Clinically Integrated Network
What is the Statera Health CIN?
A Clinically Integrated Network (CIN) is a partnership between physicians and hospitals to provide medical and wellness services to a defined population. The governance is usually a board of directors made up of equal representation from the physicians and the hospitals. The board chairperson is usually a physician.
The CIN is formed to take financial and quality performance risk for a defined population of patients. Gains (savings) are shared among the members and sometimes the members can take risks with insurers to gain additional incentive monies in return for potential losses if performance is not achieved.
The Houston County Health Care Authority and the community physicians want to optimize their ability to be successful with current and future value-based reimbursement. An organized CIN is the preferred method. Currently, the reimbursement model is still primarily fee for service; the new reimbursement model will be based on cost effectiveness and quality outcomes. A CIN can bring resources to its physician members to help them individually and collectively be successful.
The legal structure for the Statera Health CIN is a Tax Exempt For-Profit Limited Liability Company (LLC) with the Houston County Health Care Authority as the sole member. The governance of the CIN is a Board of Directors with 50 percent Physicians and 50 percent Houston County Health Care Authority representation.
The CIN operations will be supported primarily by Houston County Health Care Authority funding, but also includes a physician application fee and dues in addition to hospital participant funding.
As a Commercial CIN, we are not associated with a governmental entity; however since Medicare quality initiatives are used for Medicare “accountable care programs”, the Statera CIN may adopt quality initiatives in the future that are similar to Medicare Performance measures as its core measures.
The CIN will market its population management approach to providing health care to insurers, employers, and eventually Medicare (Medicare Advantage programs). The Hospital Health Plan employee population is an excellent starting point to prove our population management performance with little risk.