States may not have health information exchange capabilities or services available to healthcare organizations to participate in value creation activities. Services available to provide the exchange of health information between organizations can be cost prohibitive for large organizations to purchase. State Medical Societies have been stepping up to provide some technological support physician practices may need. Keeping up with the education and industry insight can be especially challenging for rural providers. Medical Societies act as a conduit of information for providers with and among their peers. Medical Societies have been instrumental in providing opportunities to close technology, educational and performance gaps for providers.
With shrinking profit margins due to reduced reimbursements, many organizations recognize the potential financial benefits in participating in quality initiatives which provide incentives for quality generating activities. Many healthcare organizations are not able to participate in an Accountable Care Organizations (ACO) because they do not meet the volume of patients or billing thresholds. Other healthcare organizations want to remain independent, but want to participate in value generating activities and payment opportunities. One answer to this dilemma is to form a Clinically Integrated Networks (CIN).
One requirement to participate in quality initiatives is the selection of a Quality Clinical Data Registry. These registries report quality data on behalf of providers in the CMS required format.
In this scenario, your state Medical Society has approached your organization, American Specialty Health (ASH), a leader in specialty health benefits management, to help recruit chiropractors to participate in CINs. Typically chiropractic care has not been included in many quality initiatives. ASH has published a 13-year study on chiropractic radiological utilization rates. This study has resulted in evidence based treatment guidelines to improve quality in chiropractic care. Your goal as the business development leader is to use your expertise to attract other chiropractors to participate in a CIN.
