UC Berkeley

Health care delivery and payment reform have intended to redesign care in a manner that is higher quality, better coordinated, and more efficient. As part of this shift, delivery systems are increasingly organizing in new ways, often moving toward greater organizational integration. One model that has emerged is the Clinically Integrated Network, or CIN, a set of independent provider organizations such as hospitals and physician groups that collaborate to provide high-value care. This dissertation examines antecedents and outcomes associated with hospital participation in a CIN.

The first study uses national survey data to identify the organizational characteristics and other foundational collaboration arrangements associated with hospital participation in a CIN. The second study evaluates CIN processes, using a survey of hospital activities to ask whether CIN-affiliated hospitals offer more integrated care delivery than hospitals not affiliated with CINs. The third study uses inpatient hospitalization data to evaluate care coordination outcomes associated with hospital participation in a CIN by testing for an association between CINs and potentially preventable inpatient utilization. Taken together, these studies provide the first national empirical evidence describing CIN activities, and the findings can help inform decisions of CIN leadership and regulatory authorities.