Clinical Integration: Committed to Quality
The Mount Carmel Health Partners Clinical Integration program has been developed to help Health Partners physicians and the Mount Carmel Health System succeed in the emerging healthcare environment. All providers will become accountable for delivering demonstrated value to patients, payers and the community. Value will be defined by the quality, service and outcomes we deliver as compared to the overall cost of care. This value will be the benchmark for provider performance and reimbursement.
It is important that our Clinical Integration program be physician-led and physician-driven in order to achieve a program which produces the greatest rewards. It must also include collaboration, guidance and support through its partnership with Mount Carmel Health System. This will enable all participating providers to achieve the desired results and be viewed as leaders in demonstrating value in the Central Ohio community.
Clinical Integration is primary care physicians, specialists and health systems working together, using proven protocols and measures, to improve patient care. The Clinical Integration program with Mount Carmel Health Partners is implementing physician-directed quality improvement programs, focusing on improving patient care and clinical outcomes, and committed to obtaining rewards for the value we provide in the market.
Once a physician chooses to sign the Clinical Integration Addendum (Legal Agreement) and sends it back to Health Partners, the physician will receive a Welcome Letter with their effective date as a participant in the Mount Carmel Health Partners Clinical Integration Program.
As a physician, participation in Clinical Integration includes:
How do you create Organizational Change?
Participation in Clinical Integration requires an organizational change for health systems and physicians. This will require members’ practice staff and clinical teams to meet the reporting requirements and clinical objectives of the program.
The Patient Registry is an electronic healthcare tool used to collect clinical and quality related data from physicians, hospitals, laboratories, pharmacies and other healthcare providers. It also provides physicians with the point-of-care tool which aids in patient and population management.
What are the Clinical Integration Committees?
Since Clinical Integration is physician-led and physician-driven, it requires active participation from representatives of all medical specialties in selected committees:
- Nominating Committee
- Quality and Clinical Integration Committee
- Clinical Process Improvement Committee
- Contracting Committee
- IT Committee
What are the Clinical Measures and Incentives?
Participating physicians will be asked to achieve specific metrics which have been implemented by peer members of the five established committees. These metrics will be used to monitor quality so that value can be demonstrated. Most pay-for-quality programs utilize metrics as a means to reward performance. Metrics are created by your peers and are established for the following specialties:
- Primary Care
- Cardiology
- Orthopedics
- OB/GYN
What are the Educational Requirements?
Successful Clinical Integration requires participation and understanding of the organization’s quality objectives from all members of the network. Specific education programs will be provided as a means of ensuring that participating physicians are aware of their obligations under Clinical Integration and to offer education for continuous quality improvement throughout the year. Participation is required. Programs will be conveniently accessible through webinars. There will also be an annual program that requires meeting attendance.