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The CHI Texas Health Network CIN is a network of independent providers, employed providers, facilities and ancillary providers collaborating to enhance the health of patients.
The CHI Texas Division developed the CIN to create improved partnerships between the health system and physicians within the community. Through the CIN, physicians will have access to a significantly larger pool of patients and acquire additional payments on top of their fee-for-service reimbursement.
Private payers and CMS continue to modify physician reimbursement methodologies that include “pay for performance”, e.g., MACRA and bundled payments. To be successful and achieve maximum reimbursement in the future, providers must identify new approaches to deliver improved quality and coordinated care to their patients in these contracts. CINs support this evolution by shifting the delivery of services away from traditional reactive sick care to approaches that are consistent with proactive well care.
To assist in maximizing contract reimbursement, CIN members have access to an infrastructure that supports this transition and assists them in achieving financial incentives through:
Yes. The CHI Texas Health Network has contracts that equate to 50,000+ lives in CY 2017, with additional contracts under negotiation.
The CIN is always researching the needs of our physician partners and seeking out new opportunities to assist physicians. As a clinically integrated network, the CIN is legally able to provide services (free and/or at much reduced rates) to support the network’s clinical integration efforts. At present, the following services are available for CIN participants:
A – CIN participants are listed in an on-line enhanced physician network tool that is exclusive to CHI employees and family members. Cost = Free.
NOTE: This service is likely to be expanded as the CHI Texas Health Network gains new contracts forged with direct-to-employer relationships so that our high quality partners have increased access to populations being managed under contracts.
B – CHI marketing is working to improve direct-to-consumer outreach to increase CIN participant utilization vs. Non-CIN participant utilization. Cost = Free.
C – Care Management support and integration with CIN participating practices. The CIN works with payers to identify the sickest members in the populations under contract. Care managers reach out to these members and: help set up appointments with their primary care physicians, assist members in improved self- management of chronic diseases and help connect patients with community resources that reduce the barriers to appropriate healthcare services.
No. The CHI Enhanced Provider Network is inclusive of the CHI Texas Health Network providers only. The Enhanced Network offers the lowest out-of-pocket expense to the employee and family member.
CMS uniformly prohibits physicians from joining more than one ACO only when joining the Medicare Shared Savings Program (MSSP). However, beyond this federal organization, it is up to each separate CIN to determine their rules on ‘exclusivity.’ For the CHI Texas Health Network, there is no exclusive arrangement that prohibits a physician from being a member of multiple organizations in these categories.
No. There are no fees associated with joining the CHI Texas Health Network CIN at this time.
Yes. Both parties (the physician and/or the CIN) have the ability to terminate physician CIN participation with advance notice. See CIN participant agreement for details.