Case Study
Competitive Repositioning
of a Regional Health System,
CIN Creation
Payer Provider Innovation
A large regional multi-hospital health system with 200 employed medical staff, and 1,100 affiliated community physicians was threatened by its major competitor’s aggressive recruitment and employment of key practices in their overlapping metropolitan service area.
As a system heavily dependent on private practice participation, leadership was seeking a new structure
to align key stakeholders in countering their competitive threat.
The health system engaged BDC Advisors to assist with its overall system strategy and develop a physician alignment plan
BDC Advisors recommended the system create a clinically integrated network (CIN) subsidiary of the system with a physician-led board of managers and invite the provider community to join. Following a series of seven meetings of a “Physician Steering Committee” led by a BDC Advisor
physician consultant, the new entity was launched with a 16-member board and a participation offer for the active members of the health system medical staff. One physician, initially skeptical of the CIN initiative, emerged as a strong proponent of the strategy over the course of the PSC meetings and became the key spokesman and leader for the new network. Over the
course of eight weeks, 900+ physicians were recruited to the new CIN
BDC Advisors then assisted leadership in designing a new physician executive model, creating three key job descriptions and identifying the leaders to fill the titles of President of the Medical Group, Chief Medical
Officer, and President of the CIN. These three leaders were added to the CEO’s executive team, creating a new degree of collaboration and leadership alignment. Over the course of the next six months, BDC Advisors
assisted the new CIN in establishing physician-led subcommittees, clarifying the “charters” of each group, designing a value-based scorecard, and putting in place a first-year CIN “workplan.” Initially, the CIN focused on the system’s employee health plan, saving several million dollars on drug spend. In the second year, the system was approached by three commercial payers wanting to explore value-based contracts, and currently,
the CIN is operating with five commercial contracts, with both quality and shared savings reimbursement opportunities.
BDC Advisors and the CIN leadership reported on the new CIN formation to
a regional hospital medical staff six months after CIN formation.
Subsequently, the local hospital formed a CIN using the health system model,
leading to the signing of a strategic affiliation agreement. This affiliate model has now become a major system, and growth is spreading to other regional hospitals.
PAYER-PROVIDER
INNOVATION
Created Sustainable Contracting Cycle and Team Redesign
