The FTC and Department of Justice have described a clinically integrated network as one that implements “an active and ongoing program to evaluate and modify practice patterns by the network’s physician participants and creates a high degree of interdependence and cooperation among the physicians to control costs and ensure quality.”
During the past five years there has been a significant increase in enforcement activity by the FTC in response to complaints alleging that physician networks are engaging in the suppression of price competition and utilizing structures that fail to meet FTC guidelines.
But the recent GRIPA opinion confirms that physicians that work together in an integrated, interdependent, quality improvement program is an achievable goal. Through clinical integration, organizations are able to improve the quality of care and achieve new efficiencies by evaluating and modifying the practice of medicine.
Clinical integration programs coordinate the sharing of clinical information between the community of physicians and hospitals, labs and imaging facilities through the use of new technology such as EMRs. There is great potential for improving care outcomes and reducing redundancy through the sharing of information. When physicians work together, they not only benefit their patients but also other physicians, health plans and the community as a whole.
What requirements and components are necessary for a successful FTC compliant clinical integration program? Can it lead to better reimbursement levels? And what other benefits can result from successful clinical integration initiatives?
Join The Managed Care Information Center and expert speakers from the legal, operations, and physician organization perspectives for “Successful Clinical Integration Initiatives in Physician Organizations: How to Build a FTC Compliant Program,” that took place in February 2008.
Here's what conference registrants had to say about this program:"Speakers were clear, well prepared, knowledgeable and followed the written materials" Phil Gautreau, VP, North Shore LI Jewish Health System
"It was very informative. There was consistency of message among the speakers. The length of the conference call was perfect at 1.5 hours. And led to a good discussion afterwards among our internal team"
"Information on both EMR-based programs and paper-based medical records; and information on what FTC deems a compliant program" Laura Hart, Director of Health Services, Secure Health Plans of GA
"It was beneficial to our organization"
“I liked being able to hear the different experiences back to back"
"Specific information was given"
"I enjoyed learning about other IPA/PHO experiences with clinical integration"
- Why Clinical Integration?
- The Benefits of Clinical Integration
- How Independent Practices Can Work Together
- Key Elements a Clinical Integration Program to Be FTC Compliant
- Potential Antitrust Issues and Solutions
- Clinical Integration vs. Financial Integration
- Best Practices for Compliant Integration
- The Necessary Steps to Become Clinically Integrated
- How to Secure the Necessary Physician Participation and Commitment
- Other Considerations in Clinical Integration
- Case Study: How Adventist Health Network recruited 600 physicians in hundreds of practices to join their PHO
- Case Study: GRIPA Connect™ Clinical Integration, the second such program in the country to receive a favorable advisory opinion from the FTC
- Question and Answer Session
Providers, hospitals and health systems, PHO and IPA's, health plans, consultants, law firms, pharmaceutical companies, medical device manufacturers, healthcare technology companies, TPAs, PBMs, and associations with titles:
Administrator, Associate Director, CEO, President, COO, Director, Division Director, Executive Director, Manager, Medical Director, President, Senior Director Operations, Director Medical Affairs, Consultant, Vice President, Director Managed Care, Finance Director, VP Business Dev & Contracting, Marketing Research Manager,Physician Practice Management, Network Development and Provider Services Directors, Network Managers, Strategic and Implementation Consultants
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