Functioning as a Clinically Integrated Network (CIN), JHN combines evidence-based medicine with an innovative pay-for-performance program. This effort to advance the Quadruple Aim is called the Clinical Integration Program (CI Program).
The CI Program is the vehicle for steering population health in the Jackson area toward value-based care. It includes critical components for success, such as patient-payor alignment goals, quality and cost metrics with measurable benchmarks, and monitoring of progress via quarterly scorecards. It is the means by which the Network negotiates dollars to incentivize and increase monetary support for the value-based care delivered to patients who are seen by JHN members.
The performance of the Network (Community Score) drives dollars into the incentive fund and then the performance of each individual physician (Individual Score) drives the amount paid to each member (as illustrated here).
When choosing effective JHN Scorecard metrics, many components are considered.
- Health Care Landscape – Program metrics should move us from volume-to-value.
- Population Health – Chosen metrics should be large enough to affect a considerable population.
- Payor Alignment – To create alignment, effectively identify and harmonize metrics with payor incentives.
- Program Engagement – Promote the engagement of both primary care and specialty care.
- Data Validity – Metric data must be valid, timely and readily generated.
There are two distinct types of JHN scorecards – a Community Scorecard which reflects Network performance and Individual Scorecards which reflect each physician’s performance. The Community Scorecard is a compilation of the work performed by all physicians in the Network and reflects the collaborative nature of our program. It provides a picture of our success as a Clinically Integrated Network. The Community Scorecard consists of six bundles of metrics.
- Bundle 1 – Preventive Care
- Bundle 2 – Chronic Disease Care
- Bundle 3 – Continuum of Care
- Bundle 4 – Quality, Efficiency and Utilization
- Bundle 5 – Patient Experience
- Bundle 6 – JHN Education and Citizenship
Individual Scorecards display how each physician performs individually for the population they serve and their contribution to the performance of the Network overall. A threshold score of 45 percent is required for individual physicians to partake in annual financial incentive rewards.
The Individual Scorecard includes all six bundles above as well as Bundle 7 – Specialty Metrics. Bundle 7 metrics were added to the CI Program Scorecard in 2020 to enhance the engagement of specialists. More specific alignment of metrics with day-to-day work has increased specialist satisfaction and commitment to the CI Program.