The largest medical center and largest group of doctors in the region have announced plans to establish a network to offer more integrated health care.
The goal of creating what’s called a clinically integrated network (CIN) involving St. Mary’s Hospital and Regional Medical Center and Primary Care Partners is to provide better care at a lower cost, administrators said.
“The Mesa County health care community is nationally known for working collaboratively to the benefit of our patients, and the formation of a CIN is another example of this,” said Michael McBride, president and chief executive officer of St. Mary’s.
Dr. Michael Pramenko, executive director of Primary Care Partners, agreed. “In a CIN structure, the basis of cost savings is providers working together on a patient’s care, sharing information, best practices, helping those with chronic conditions manage their health so they can stay out of the emergency department and out of the hospital.”
The first phase of the effort is expected to take six months and focus on completing the legal and organizational work to establish the network. This will include creating a leadership structure, developing the operational components of the network and identifying other potential participants. Navigant Consulting, a health care consulting firm based in Chicago, has been retained to guide the effort.
A clinically integrated network brings together a hospital, physicians and other health care providers to care for patients while maintaining separate business entities. Networks include not only care coordination programs, but also computer connectivity and data analysis, contracting services, financial underwriting and performance measures.
A network can contract with insurance companies and health plans as well as employers that provide self-funded benefits to employees.
“Because a CIN can include independent physicians, hospital-employed physicians, ambulatory centers and a hospital, it offers businesses and their employees more choice with a wide, inclusive network rather than an exclusive network,” McBride said.
Pramenko added: “It’s based on providing cost-effective care rather than restrictive access to care that some other network models use to lower costs.”
St. Mary’s operates the largest medical center between Denver and Salt Lake City with a hospital with more than 350 beds, a staff of 2,000 and 300 doctors practicing in 50 specialties.
Primary Care Partners operates the largest physician group in Mesa County with a total of more than 54 providers in five practices and an after-hours urgent care facility.