Topics: Physician Issues, Hospital-Physician Alignment, Clinical Integration, Accountable Care, Market Trends, Strategy, ACO

New interest in a long-standing alignment platform

Despite the recent growth in interest, CI is not a new phenomenon. Federal regulators first defined the strategy in 1996 as part of new guidance on health care antitrust enforcement. Under this definition, CI can provide an antitrust safe harbor for physicians who collectively invest in performance improvement. In exchange for their commitment to improving patient care, physicians in a legally viable CI network may negotiate jointly for contracts with commercial purchasers, activity that would normally be prohibited as collective bargaining.

Although the legal framework for CI was laid more than 15 years ago, uptake of the strategy took time. The first formal favorable advisory opinion for a CI program was issued in 2002, followed by a handful more in subsequent years. Not until a few years ago did industry interest begin to broaden. The Health Care Advisory Board published its first study on CI, Building the Performance-Focused Physician Network, during this time to provide guidance around how to assess CI feasibility and launch initial network development.

CI Now a Widely Embraced Strategy, but Initially Slow to Get Off the Ground

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An explosion of interest in the clinical integration model

Industry changes now driving many to embrace CI