ISBN:  Unavailable

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Page count: 15

In response to the Patient Protection and Affordable Care Act, health care organizations have sought ways to increase efficiency quickly, improve their ability to coordinate care, and enhance patient outcomes as reflected in publicly available performance measures. One such response has been the emergence of the clinically integrated network (CIN), commonly defined as a group of health care providers that join together to improve patient care, reduce costs, and demonstrate market value. The Federal Trade Commission (FTC) and U.S. Department of Justice have jointly provided guidance for CINs to determine whether cooperation among these otherwise competing organizations to jointly negotiate fees runs afoul of antitrust law. However, little is known about whether CINs conform to FTC guidance. The FTC does not formally monitor CINs, and health systems wanting to establish a CIN are not required to seek FTC approval. As a result, CINs are basically invisible to regulators and health services researchers, although CINs have the potential to produce negative market effects, such as increasing prices without a corresponding increase in quality. In this report, the authors offer an initial assessment of CINs based on interviews with health system executives, describe how health systems (large and small) are using CINs strategically to compete in crowded health care markets, and identify why CINs bear watching by the FTC and the larger health care community.