Clinical Connection

The CIN is a physician-led, physician-governed collaboration between Johns Hopkins Medicine (JHM) and external practices that can benefit both physicians that participate and their patients. The network is inclusive of adult and pediatric services, and seeks to improve patient experience, enhance coordination of care and support physicians in value-based care.

Vision:

The Johns Hopkins Clinical Alliance will transform the health of patients in the Mid-Atlantic region through access to an exceptional integrated physician network. This network will create value through focus on quality of care and seamless coordination between providers.

Mission:

To share clinical expertise with like-minded physicians to move health care forward — together.

All Johns Hopkins Medicine-employed physicians will be part of the JHCA as will a select group of high-quality independent physicians.

JHCA will provide greater opportunities for value-based contracts and enhanced care-coordination for managed patient lives. It will also provide an infrastructure that allows physicians to make more informed decisions about their patients. Some benefits include, but are not limited to: enhanced coordination through appropriate referrals, clear lines of communication with other physicians providing care, ongoing education on the concepts and tactics of value-based care, access to performance analytics to facilitate improved patient outcomes, and a team approach that produces better outcomes.

There are many similarities between ACOs and CINs, as both share the objective of improving the quality of patient care while reducing costs. They do this through creating an aligned infrastructure with extensive IT integration and care coordination to reduce costs, close care gaps and improve outcomes. Both also have incentives and payments that are tied to patient outcomes (e.g., quality and performance).

While the two have these commonalities, there are some key differences:

• Populations managed: ACO programs are specific to Medicare patients, while CINs can include commercial and other government payors.
• Legal structure: ACOs follow strict rules to structure their entity in accordance with CMS guidelines, while CINs have a legal structure that can evolve as needs change.

JHCA has a board of directors as its governing body. As with other parts of the CIN, the board will be physician-led and will therefore be composed primarily of physician members from across Johns Hopkins Medicine and independent practices.

No. There are no patient referral requirements to participate in JHCA. For purposes of enhanced coordination of care, we do encourage collaboration with JHCA physicians where available and clinically appropriate. Coordinated and tightly aligned networks improve the quality of care delivered and boost patient satisfaction.

JHCA is a nonexclusive network and does not require participating physicians to leave other CINs. As such, independent physicians may contract with payors directly and independently, or through another clinically integrated entity. Nevertheless, for each payor, a practice can only participate in one value-based arrangement at a time.

JHCA will work with commercial, Medicare Advantage and Medicaid payors to establish value-based arrangements. Typically, agreements include HEDIS-based quality outcomes and process metrics, with the potential for utilization metrics as well.

Value-based contracting requires active participation and continuous process and quality improvement.

One of the hallmarks of a CIN is shared data. JHCA will use a third-party resource that will pull data from electronic health records (EHR) and practice management/billing systems along with other feeds and claims data from payors to create a robust, longitudinal patient record. The system will comply with all applicable laws and regulations protecting data privacy, including HIPAA.

The data will ultimately be used to:

• Assist participating physicians in adhering to clinical protocols, such as tracking whether a patient has received certain preventive services.
• Report on quality measures for the CIN.
• Provide data analytics to identify those patients for whom certain interventions are appropriate, allowing participating physicians to manage those patients more effectively.
• Assist the CIN in tracking care costs to identify opportunities for improvement.
• Effectively coordinate patient care (especially for high-risk patients), improving outcomes and reducing costs.

No. A third-party data resource will connect to, and retrieve data from, each participating physicians’ electronic vendors.

Participating physicians agree to assist the CIN to implement effective clinical integration policies, procedures and protocols. This includes a high degree of cooperation, collaboration and mutual interdependence with other participating physicians, including having performance measured against performance standards adopted by the CIN, and to implement corrective action if their performance does not meet such standards.

Care management is an important component in helping participating physicians more effectively manage high-risk populations. While high-risk patients make up a smaller number within a participating physician’s patient panel, there is a disproportionate amount of resource utilization. For patients under management, JHCA will proactively work with participating physicians to identify and connect them with appropriate network resources to coordinate and further enhance care. This includes assisting patients in obtaining needed services to improve quality while addressing gaps in care.

Yes. The use of an EHR system is required for participation with JHCA.