The medical neighborhood is one approach to defragmenting care coordination in the United States.
The need for better coordination within the U.S. healthcare system cannot be refuted, notes Terry McGeeney, MD, MBA, director of BDC Advisors, who introduces the trend toward medical neighborhoods.
We need to start talking about the solution to bridge the gap between health systems and physicians. We can do that as we talk about the medical neighborhood concept and the integrated network concept. I have come to realize that the medical neighborhood in many environments is a physician term that’s been embraced widely by both specialty organizations and primary care organizations.
A clinically integrated network (CIN) is a hospital term. These CINs have been around since the late nineties, when they were established by the Federal Trade Commission (FTC) and Federal Communication Commission (FCC). And you will often hear hospitals talking about clinical integration. The difference is that until the last couple of years, clinical integration has often been within the four walls of the hospital, where now it’s being expanded to broader networks around population management.
What are these medical neighborhoods that we are talking about and where are they? When you want to look for a medical neighborhood, look no further than your CIN for the foundation of that network. The challenge you often see is that the CIN or clinically integrated entity was set up as a legal entity and is not necessarily a high functioning medical neighborhood. It may have been set up by a law firm, or an accounting organization. It meets all the legal requirements, but it may not meet the requirements needed for improving quality of care in lowering cost.
But that existing CIN does create a foundation from which you can work. What you want to work and think about is transitioning your clinically integrated entity to a high functioning medical neighborhood. And to me that’s the real opportunity, but also a significant challenge.
Excerpted from: Driving Value-Based Reimbursement with Integrated Care Models
