Blog Post

How health IT and artificial intelligence can help clinically integrated networks manage risk — and contract-based performance

Share this post:

As new value-based payment models continue to be introduced and the healthcare industry adjusts to changing regulatory demands, provider reimbursement will depend more and more on the quality of care delivered. And in many clinically integrated networks (CINs), these new payment models are driving meaningful changes in how providers view and manage healthcare resources.

While CINs may not be designed specifically to help negotiate contracts, they do help demonstrate value (that is, the highest-quality care at the lowest cost), which in turn helps them succeed with various kinds of value-based contracts.

Within the spectrum of value-based reimbursement, a CIN may hold contracts for pay-for-performance, upside-only risk, two-sided risk and bundled payments. To succeed in these kinds of agreements, we believe a CIN requires a cluster of capabilities that supports key factors such as provider performance management; financial risk management; and the ability to correlate quality, cost and efficiency data.

Those capabilities could include an advanced health IT infrastructure; the ability to collect, integrate and analyze data; and artificial intelligence (AI) to apply myriad risk models.

With the right analytic insights, a CIN can not only stratify patients by risk, but also provide insights in near real-time about which areas of care delivery are costing the most and why, and what CINs can do about it.

Learn more in Part 6: Contract management from our CIN-focused playbook, Powering your clinically integrated network with advanced health IT, which delves deeper into the topic of using advanced IT and AI to support contract performance and risk management.

 

 

More Blog Post stories

Hospital Pharmacists Tap AI to Improve Drug Information Searches

Written by Watson Health | Blog Post, Value-Based Care

Among the dozens of hospital pharmacists who have been testing new technology in a limited availability roll-out, all have made it clear that their number one priority is to make sure the information they are delivering to their colleagues and friends is rock solid. ...read more


IBM Watson Health taps hospital clinical data to improve sepsis care

Written by Watson Health | Blog Post, Value-Based Care

DeKalb Medical and AHMC Healthcare leveraged data and clinical care team capabilities to make improvements in sepsis care. ...read more


Schneck Medical Center: Improving population health management with near real-time data

Written by Watson Health | Blog Post, Value-Based Care

This blog post contains an interview with members of the Schneck Medical Center team on how they use data to develop programs and processes that improve population health management efforts. ...read more