Assisting a PHO to Pursue Clinical Integration
Client/Profile
A physician-hospital organization comprised of a 400-physician independent practice association and a large academic medical center
Challenge/Situation
To assess readiness for clinical integration and develop a roadmap toward achieving it, given current capabilities.
Process
Veralon worked with the PHO and physician leadership to assess clinical integration goals. Veralon assessed requirements to attain both functional clinical integration and clinical integration as defined by the Federal Trade Commission.
Veralon assessed the PHO’s capabilities to engage physicians in care redesign, gain access to required patient data, capture and report on quality data, and manage innovative payments. The group considered different approaches to overcoming identified gaps. For instance, should they leverage existing hospital EMR capabilities or purchase or lease a data aggregator solution? Should the PHO provide care management resources or leverage the hospital’s care management capabilities?
Results
Veralon then developed a detailed business plan with a three-year financial outlook. Veralon has continued to support implementation efforts, including developing a gain-sharing model.