Our client’s fragmented CIN network structure led to inconsistent inpatient utilization management, elevated post-acute costs, and poorly coordinated care transitions. Without real-time visibility into patient movement or clear accountability across care settings, the organization faced unnecessary spending, variable quality outcomes, and significant operational gaps that limited its readiness to assume global risk. These disconnects hindered the CIN’s ability to manage populations proactively and perform effectively in value-based arrangements.
How an Integrated Care Management Strategy Positioned a CIN for Success in Global Risk Arrangements
- Home
- How an Integrated Care Management Strategy Positioned a CIN for Success in Global Risk Arrangements
Clinically Integrated Networks (CINs) face increasing pressure to manage cost, quality, and utilization as they move toward global risk arrangements. Effective readiness requires real-time visibility, coordinated care transitions, and integrated care management capabilities across inpatient, post-acute, and home settings.
This case study highlights how our approach helped a fragmented network build the foundation needed to succeed in risk-bearing models.
Challenge
Solution
We implemented a comprehensive, integrated care management strategy designed to improve utilization, strengthen care transitions, and build readiness for global risk. The program leveraged real-time ADT feeds, EMR integration for seamless information flow, hospital-based nurses to manage inpatient episodes, and in-home nurse practitioner visits to support high-risk members. This end-to-end model improved coordination, reduced avoidable utilization, and established the operational infrastructure required for CINs to succeed under global risk.
Results
- Reduced acute admits from 160s to 140s
- Readmission rates consistently <15%
- 100% of patients received post-discharge follow-up
- Improved care coordination and positioned CIN for global risk
Key Takeaway
Our approach shows how a CIN can rapidly build the infrastructure, processes, and care management capabilities needed to succeed in global risk. By embedding care management at every transition of care, the organization reduced costs, lowered variability, and improved value-based performance. This model consistently delivers industry-leading inpatient bed day results and meaningful downstream impacts across the care continuum.