The Value of Clinical Integration

The goal of clinical integration has always been and will continue to be the delivery of quality care to patients in an efficient and sustainable manner. Through our clinically integrated network, Mount Carmel Health Partners is doing our part to accomplish that goal while also positioning our physicians and their practices to capitalize on the opportunities this evolution in healthcare presents. The good news is there are scores of benefits for patients and physicians, as well as employers and payors, in this value-driven model.

For Patients
  • Better value for their healthcare dollar
  • Improved access to healthcare services and providers
  • More effective care coordination, management, and outreach from a trusted source — their physician
  • More reliable information to support their choice of health plans, physicians and hospitals
  • Greater stability in their relationship with their doctor and hospital and less likelihood that they will need to choose new healthcare providers mandated by changes in their insurance plans
  • Emphasis on communication, patient wellness and engagement tools, and reducing risks for serious health issues and complications
  • Improved access to health and wellness classes as well as education programs designed to help manage chronic conditions
For Physicians
  • Access to over twenty payor contracts including commercial, Medicare Advantage and Managed Medicaid
  • Elimination of direct payor credentialing thanks to Health Partners’ NCQA Certification in Credentialing and Recredentialing
  • Increased ability to identify and address gaps in care and provide patient outreach
  • Tools to measure and compare patient care performance
  • Collaboration with providers driven to create innovative solutions for building a better healthcare system
  • Access to population health management and clinical performance reporting systems
  • Enhanced revenue through performance-based incentives that link reimbursement and outcomes performance
  • Ability to demonstrate clinical quality to patients utilizing guidelines developed by Health Partners
  • Greater access to continuing education, courses and seminars focused on increasing physician success as well as practice staff readiness
For Employers and Payors
  • Ability to more effectively manage the costs of employees and their dependents through more efficient healthcare services
  • Increased employee productivity and reduced absenteeism through the better management of chronic disease
  • Lower long-term healthcare costs by reducing the variation in physician practice patterns
  • Match key populations and healthcare needs to services
  • Increased compliance with quality/HEDIS metrics
  • Easy access to objective quality and utilization data and metrics to track baseline and measurable improvement over time
  • Evidence-based care processes, policies and procedures
  • Consistent care across providers to achieve similar outcomes
  • Feedback loop to continually improve care process design
  • Enhanced patient satisfaction and outcomes by embedding care management into benefit and incentive structures
  • Comprehensive product offerings for wellness and occupational health services
  • Innovative benefit solutions including limited network products