Trinsic is the name of the clinically integrated network (CIN) developed to reduce costs and redundancy in healthcaredelivery operations for its members.
It promotes the CIN payment model that rewards value rather than volume. Currently Trinsic is in the process of building its infrastructure and is focused on Primary Care physicians. Future plans will involve the inclusion of Specialists.
What is the role of specialists in a value-based care (VBC)?
- Collaboration on continuous improvement. Specialists are key partners for delivering value-based care especially for patients with chronic diseases.
- Use of lowest appropriate site of care. Specialists who care for patients with complex, chronic medical condition influence overall cost of care (ie: chronic care management amounts to $220 billion in healthcare spending annually). A large proportion of this cost is variable and could be reduced if patients are kept out of acute care settings.
- Furthering evidence-based practice and patient centeredness. Under value-based care agreements, providers are rewarded for helping patients improve their health, reduce the effects and incidence of chronic disease and live healthier lives in an evidence-based way.
- Embracing robust data usage and performance metrics. Unlike the traditional fee for service model, value-based care is driven by data and providers must report to payers on specific metrics and demonstrate improvement. As part of a CIN, Trinsic tracks and reports on hospital readmissions, adverse events, population health, patient engagement, and more on behalf of its partner practices.
- Participation in pathway development. VBC can provide rapid dissemination of information and feedback exchange to develop new clinical pathways.
- Engagement and cost management. Adopting VBC will allow specialists to demonstrate continuously improving patient care outcomes and savings but also potentially enhance financial rewards by shared savings and other revenue enhancements.
What should specialists do now if they might want to join Trinsic in the future
- Specialists should assess where they’re at in their own value-based journey against the success factors for value-based care. To succeed in value-based arrangements, provider organizations must consistently deliver high-quality care, earn excellent patient experience ratings, continually ratchet down the costs of care, and prove it with metrics that their payers agree to use.
- Specialists can evaluate internal opportunities and begin to execute on them. Look at ways to improve quality, improve patient experience while lowering the cost of care. Setting up ways to track this information will be vital.
Which contracts will be part of Trinsic when it officially launches in January, 2024?
To join Trinsic, participating providers must agree to participate in all appropriate/available value-based contracts held by the network in at least one of the categories: Commercial or Medicare Advantage (some plans may change due to ongoing negotiations).
Commercial
-Aetna
–Anthem BCBS
-Cigna
-Select Health (individual Exchange plans — 2024)
–UnitedHealthcare
Medicare Advantage
-Aetna
-Anthem BCBS
-Cigna
-Humana
-Select Health (2024)
–UnitedHealthcare
-Original Medicare (MSSP)
Note: Trinsic evaluates new and existing contracting opportunities, in accordance with Board approved contracting parameters, on an ongoing basis. This helps to maximize performance and to mitigate risk.