What is a Clinically Integrated Network?

A Clinically Integrated Network (CIN) is a formalized business entity between independent physicians, employed physicians, and Thibodaux Regional Health System based on developing and implementing evidence-based, data-driven clinical initiatives to improve outcomes, increase efficiency, and reduce costs in the inpatient and outpatient setting. By sharing data and representing a broad cross-section of the community, the CIN can negotiate payor contracts as a network—in a way that does not violate antitrust laws—to align payments and incentives with the performance and quality of the care delivered.

Who will lead the CIN?

CIN operations and governance are physician-driven and physician-led, supported by an advisory team composed of hospital executive support and physician leaders. The Board of Directors will be comprised of physicians who represent primary and specialty care, and Thibodaux Regional Health System executive leadership.

How is the CIN structured?

The Board of Directors in accordance with the Executive Director will guide the day-to-day operations and strategic decisions. In addition to the Board, there will be four working committees; Quality and Credentialing; Finance, Contracting, and Network Development; Patient Engagement; and Cost.  The CIN is a LLC owned by Thibodaux Regional Health System.

What Benefits does the CIN provide to the Physician, Practice, and Patients?

The CIN will prepare you and your practice to better navigate changing reimbursement and health care reform while preserving your independence by entering into new and innovative contracts with payors and employers. In addition, high-performing physicians have the potential to receive performance incentives. The CIN will also provide access to resources such as population health management, care coordination, and data analysts to identify care gaps and areas of opportunity for enhanced patient care. Lastly, the CIN will focus on alleviating the administrative cost burdens of operating in the current healthcare regulatory market. The CIN will identify opportunities for group purchasing arrangements, multi-group access to health insurance, malpractice insurance, and education/training opportunities. Through physician input, the CIN wants to continue to address the needs of its physicians on an ongoing basis.

What happens if I do not sign up for the CIN?

Non-CIN practices will not have access to negotiated CIN contracts. In addition, the CIN will be involved in a variety of value-based care contracts. This may include narrow networks and accountable care programs that require referrals to in-network physicians based on benefit design, so there is potential disruption to referrals and access to lives. Due to some of these networks being narrow and requiring referrals to only in-network providers to ensure a member receive the highest benefit, the CIN will look to refer to physicians that are part of the CIN. With that said, members/patients will always have a choice, but may look to stay within a network to ensure they pay the least out-of-pocket.

What are the costs to participate in the CIN, including technology and payback of start-up costs?

There will be no up-front costs to join the network. Any future fee would be based on a fair market value assessment due to participants receiving significant value from the network.

By agreeing to participate in the CIN, will I be required to abandon medical staff appointments at non-CIN hospitals, as well as admit patients only to Thibodaux Regional?

No. The CIN is a non-exclusive organization, making no limitations on the physicians’ ability to admit patients to non-CIN facilities. However, by being collaborative members of the CIN, Thibodaux Regional will strive to demonstrate high-quality and efficient care that will be desirable to referring physicians.

If the CIN is contracting on my behalf, what happens to my existing contracts?

You will maintain the direct contracts you have through your practice with all payors. The contracts negotiated by the CIN are considered an “overlay” on those direct contracts, and are designed around specific performance metrics to improve outcomes for a designated patient population. Your existing fee-for-service contracts would not be impacted. The CIN Board of Directors will decide if/when the network should negotiate fee schedules or enter into additional contracts. The network would be notified if this takes place.

How will quality be measured by the CIN?

Each specialty and primary care will have quality measures selected by the CIN Quality and Triple Aim Committee. Most are standard measures and will initially be based primarily on claims and hospital data. The measures will change over time to align with CIN quality initiatives and payor expectations, as well as ease of data collection. Physicians will be providing input on measures that are meaningful for the community, their own patients, and for their own specialties that make sense to the network.

What do I have to do to join?

Sign a participation agreement. There is no monetary fee. You’ll be required to submit data from your practice management system to report out quality measures and initiatives.

How can we learn more about the CIN?

Contact Kim Legendre-Boudreaux , CIN Manager, for more information at 985-493-4907 or kim.legendre@thibodaux.com