What is the Henry Mayo Newhall Care Network?
Henry Care Mayo Newhall Care Network is a Clinical Integrated Network (CIN). A CIN is a healthcare network that coordinates care across providers and sites-of-care in a manner that enhances value for consumers by improving quality and patient satisfaction, while at the same time, lowering healthcare costs.
We believe that greater clinical integration, collaboration and shared accountability through a network of physicians will lead to better health outcomes for the people of Southern California and in particular Santa Clarita.
To learn more, please see the FAQ section below.
Frequently Asked Questions (FAQs)
What is a Clinically Integrated Network?
A Clinically Integrated Network (CIN) is a healthcare delivery network, comprised of physicians and health systems, that coordinates care across providers and utilizes evidence based care in a manner that increases value by improving healthcare quality, improving the patient’s experience of care, and enhancing health while positively influencing the healthcare cost trend. The Federal Trade Commission (FTC) has developed a definition of clinical integration that includes “an active and ongoing program to evaluate and modify practice patterns by the network’s physician participants and create a high degree of interdependence and cooperation among the physicians to control costs and ensure quality”. This program may include:
establishing mechanisms to monitor and control utilization of health care services that are designed to control costs and assure quality of care;
selectively choosing network physicians who are likely to further these efficiency objectives;
significant investment in capital, both monetary and human, in the necessary infrastructure and capability to realize maximal efficiencies.
CINs that meet FTC requirements can serve as a platform for developing value based contracts with commercial and governmental payers on behalf of health system and physician participants.
What are the objectives of the Care Network?
Commit to providing quality care and to improving the health of the communities we serve while bringing increased efficiency and positively impacting the cost trend of health care.
Develop a physician-led and professionally managed entity that promotes integration and collaboration within the clinical community.
Develop a mutually beneficial partnership between Henry Mayo Newhall Hospital and physicians with a commitment to quality and service.
Develop and/or adopt clinical protocols grounded in evidence-based medicine.
Improve access and care coordination for the people we serve.
Measure and reward the quality of care delivered.
Provide programs and services that support physicians in achieving economic incentives related to value-based payment models.
Provide a vehicle for single signature contracting and for physicians to share in the savings based upon performance.
Why are we doing this now? Why not wait?
Healthcare is changing dramatically toward value-based care and payment rather than the traditional fee for service model. Healthcare providers need to learn how to work together and develop new ways to provide value based-care for our patients. It will take time and an investment of funds to develop the infrastructure we need to succeed in the future, such as information technology, care management programs, etc.
In addition, healthcare providers are continuing to consolidate on a regional basis. In an environment of intense competition, we believe a CIN is the best opportunity for physicians in this market to maintain independence of practices but benefit from a network with value based care capabilities. Now is the time to work together to define quality evidence based patient care and the metrics that will be used to measure our practices before another organization defines it for us.
Why is this important in our market?
The provision of health care, and specifically, the way it is being reimbursed, is changing very rapidly to a value-based payment model. We believe that the CIN concept, coupled with value-based contracts with payers, provides a vehicle for hospitals and physicians in our market to work together to improve the health of the people of our community. It allows us to learn how to best coordinate care, utilize information technology, and create appropriate, aligned incentive structures while incrementally moving toward more value-based risk contracts. We would rather do this incrementally at a reasonable pace and take advantage of the opportunity to learn, as opposed to waiting and having changes forced upon us in the future by the government and other payers.
What is an HQEP?
In addition to value-based contracts with payers, many CINs include an incentive program between participating physicians and the sponsoring health system to increase quality and reduce cost within the hospital. This type of arrangement is known as a Hospital Quality & Efficiency Program (HQEP). Quality and cost initiatives are defined by the CIN Quality Committee through a set of initiatives and metrics, each with its predefined baseline and performance targets. As HQEP quality or cost targets are achieved, the health system distributes funds to the CIN based on the aggregate performance of its participating physicians. The CIN, in turn, distributes funds from the HQEP incentive pool to participating physician groups based on the contribution of its group members.
What is the value of partnering with the Care Network?
The CIN brings together a network of providers who are united in a common goal: Delivering quality care to patient health in a more cost effective manner.
CIN members will be part of a physician-led and professionally managed approach to delivering quality and efficiency in health care. Physicians will have an opportunity to lead and shape the future of health care in Southern California while being supported by the CIN, which can draw upon existing innovative tools and services already in place with Henry Mayo Newhall Hospital.
Membership benefits include:
Physician Leadership on Board and Committees: The Henry Mayo Care Network Board and Committees is comprised of and led by physicians with decision making oversight on quality, financial, and operational initiatives.
Remain Independent: Partner with Henry Mayo Care Network and retain independence while having the ability to leverage the health system’s available resources.
Care Management: Support from experienced staff who proactively reach out to your patients for chronic care management and preventive care for conditions such as diabetes, COPD, CHF, and Chronic Depression.
Quality Improvement: Be part of a care team approach that uses evidence-based best practices that promote high-quality clinical outcomes.
Technology Support for Clinical Integration: Access health information technology for better patient care and safety. Receive support in meeting meaningful use and MACRA’s QPP standards in an ever-changing health care landscape.
Enhanced Pay for Performance Opportunity: Play an active role in a model that measures and rewards quality of care beyond the terms and conditions of traditional fee for service payer contracts.
What do physicians commit to by being a part of the Care Network?
By being a member of the CIN, physicians commit to helping provide better and safer care for patients by:
Sharing clinical information with other network clinicians.
Adhering to appropriate evidence-based quality protocols for inpatient and outpatient care.
Learning and applying the science of population management and best practices to improve the health of their patients.
What is the leadership structure of the Care Network?
The Henry Mayo Care Network is governed by a physician-led Board of Managers. The Board includes 12 Henry Mayo Newhall Hospital physicians and 4 hospital representatives.
Will physicians be able to maintain their autonomy?
Participation with HMCN offers physicians the ability to maintain their current business model as a private practice physician while gaining enhanced access to resources and services that support their practice’s success in a growing value-based payment world. On behalf of its members, the Care Network will engage payers in innovative, value-based contracting that aligns improved patient outcomes with financial rewards.
What are physicians’ risk in participating?
Normally, the only expenditure a physician participant makes is an expenditure of time. You will not be asked to financially invest directly in the CIN entity, as is typical of other types of agreements like a joint venture. The Henry Mayo Newhall Hospital is capitalizing the venture. Your current contractual relationships with payers will not be impacted by your participation in the CIN.
What, if any, are the short-term financial commitments being asked of physicians? Do physicians need to put money in up-front to participate? If so, how much?
No, physicians are not being asked to share any financial risk.
Can physicians participate in more than one program?
It depends. Primary care physicians typically cannot participate in more than one Medicare Shared Savings Program due to the patient attribution methodology defined by CMS. However, primary care physicians may be able to participate in other programs within the CIN. Specialists are able to participate in more than one CIN. The Henry Mayo Care Network Board will consider this question and you will know your options before you are asked to commit to the CIN.