Clinically Integrated Networks (CINs) enable health systems and providers to deliver value-based care, improving clinical outcomes, cost efficiencies and patient satisfaction. The organizational framework of a CIN also provides legitimacy to negotiate with payers. But, structuring a CIN is complicated and comes with compliance risks. The U.S. Federal Trade Commission, Department of Justice and state regulators closely scrutinize the structures of these networks to safeguard against antitrust violations.
CINs are choosing URAC Clinical Integration Accreditation to demonstrate clinical integration, navigate the complex requirements of the FTC and DOJ to avoid regulatory and legal pitfalls, and empower the organization to implement the proper operational and compliance foundations to ensure success with payers and partners.
You’ll hear from Casey Osborne, Vice President, PCCN, and Ginger Hines, Senior Director of Operations, SCCN, on why they chose to pursue accreditation and their experiences in the accreditation process. Find out how the process of URAC accreditation helps create a sustainable framework for clinical integration and walks the organization through the steps for setting up a network aligned with the FTC guidelines. You’ll discover how Clinical Integration Accreditation helps to:
- Negotiate from a stronger position with payers and partners
- Achieve better agreements and delegated services in medical management under value-based and risk arrangements
- Avoid the complex reviews by legal counsel and consultants (PCCN is able to budget less money for legal and consulting fees)
Plus, Osborne and Hines will provide tips on the accreditation process including:
- How to establish a roadmap to launch CIN accreditation activities at your organization to achieve clinical integration standards
- Tips to organize your efforts for the submission requirements
- How to ensure your team is on board with the final documentation that is submitted to URAC
- Resources required and the time to get accreditation
- The proper team and approach to work through the accreditation process
- What to expect during the desktop review and onsite audits
- The role that care coordination programs play in Clinical Integration accreditation
- The role of the health system or hospitals in the accreditation process
- And much more.
Don’t miss this great opportunity to hear from two CINs – one that recently became URAC accredited for clinical integration, and one that is currently going through the process – on their experiences. Plus, you’ll get a chance to ask the speakers questions directly through the live Q/A session in the last 30 minutes of the webinar.
ABOUT THE SPEAKERS
Casey Osborne, Vice President, Phoenix Children’s Care, has oversight and responsibility for Payer and Provider Operations, as well as the health system’s Physician Relations Department and Provider Enrollment Department. Under his leadership, PCCN has grown to become the first pediatric, URAC Accredited, Clinically Integrated Network in the country and has grown to be recognized as one of the top pediatric clinically integrated networks in the nation. PCCN manages over 150,000 children in various risk based shared savings and pay for performance models. Casey is also is involved with strategy around the approach to integration and pediatric care for Medicaid lives in the state of Arizona.
Ginger Hines, Senior Director of Operations, Seattle Children’s Care Network, is an accomplished healthcare leader with more than 25 years’ experience in healthcare administration, operations and management consulting. Her work for the past four years has focused on delivering new models of care, interventions and care transformation efforts for populations in accountable care and value based risk arrangements. Before joining Seattle Children’s, Ginger was the Senior Director of Operations and Model of Care for Providence Health and Services in the Population Health Division.
Deborah Smith, MN, RN-BC, URAC’s product development principal, has previously served URAC as a senior advisor for strategy and innovation, director of product development, consultant, and volunteer with URAC for more than 18 years. She recently oversaw the development of URAC’s Telehealth Accreditation program and the redesign of the organization’s patient centered medical home (PCMH) program.