Hospital Characteristics Associated With Clinically Integrated Network Participation

Area of Science:

• Healthcare Management
• Health Services Research
• Health Policy

Background:

• Hospital and physician organization integration often fails to improve clinical integration or patient outcomes.
• Federal regulators support clinically integrated networks (CINs) for coordinating hospitals and physicians.
• Existing hospital affiliations like IPAs, PHOs, and ACOs may facilitate CIN participation, but empirical evidence is lacking.

Purpose of the Study:

• To quantify hospital participation in CINs.
• To examine factors associated with CIN participation, specifically hospital organizational affiliations.
• To analyze the relationship between IPA, PHO, and ACO affiliations and CIN participation.

Main Methods:

• Analysis of data from the 2019 American Hospital Association survey (n=4405).
• Quantification of hospital participation in CINs.
• Multivariable logistic regression models to assess associations between hospital affiliations and CIN participation, controlling for market and hospital characteristics.

Main Results:

• In 2019, 34.6% of hospitals participated in a CIN.
• Larger, not-for-profit, and metropolitan hospitals showed higher CIN participation rates.
• Hospitals in CINs were significantly more likely to have IPA, PHO, and ACO affiliations compared to non-participants.

Conclusions:

• Over one-third of hospitals engage in CINs, despite limited evidence of their value.
• CIN participation may be driven by organizational norms favoring integration.
• Further research is needed to refine the definition of CIN participation and differentiate overlapping organizational involvements.