Improving Value and Care Metrics Through a Clinically Integrated Network
Can a clinical standards-based infrastructure that pulls data from all participants finally get at the intersection of cost and quality?
This article first appeared in the January/February 2017 issue of HealthLeaders magazine.
Healthcare has always searched for the holy grail—the disruptive force, construct, or innovation that will make vast and necessary improvements in quality while simultaneously slowing healthcare's rapid cost growth. Yet such a solution has eluded everyone from policymakers to patient advocates to senior healthcare executives.
Big data might be a revolutionary advance in healthcare, but without the right tools and tactics, big data won't provide insights to help improve outcomes and value. It will just be a repository of information that doesn't live up to its potential. Many organizations see big data's possibilities and are betting that the right tools and strategies coupled with an organizational structure that gathers data from disparate parts of the healthcare service universe—otherwise known as clinically integrated networks—will yield big gains in both efficiency and quality.
Organizations certainly don't see big data/CIN arrangements as a panacea. It's a relatively untested strategy to weave together incentivized and symbiotic business relationships without the need for any entity to acquire those assets. So while healthcare's holy grail has not been found and may never be, executives believe CINs hold great promise.
The intersection of cost and quality might be better called efficiency. And if any industry has ever needed a high dose of efficiency, healthcare is it.
CINs are designed to improve that metric in part by applying standards of care based on a patient's disease state for which clinicians are held accountable. Healthcare organizations are eagerly embracing CINs as a structure that allows efficiency to flourish without the huge cash outlays necessary to acquire healthcare business assets. The strategy is a timely one: Further stratospheric growth in healthcare spending is far from certain, with healthcare expenditures already accounting for 17.5% of U.S. economic activity and growing faster than GDP as a whole. Organizations that can manage efficiency well should be well positioned for slowing growth in the long term.