When Phoenix Children’s Care Network (PCCN) became the first clinically integrated pediatric network to achieve URAC accreditation in April, it blazed a trail that other children’s hospitals are starting to follow.
“I just had a call this morning with a clinically integrated pediatric network that’s starting to go down the URAC path,” says Casey Osborne, PCCN’s vice president. “They see it as a viable path for creating their network.”
Phoenix Children’s Hospital began its journey toward clinical integration five years ago when it launched a growth plan to provide care management and population health management services for many of its payers. Today, PCCN is the largest pediatric-dedicated, clinically integrated organization in Arizona and one of the few networks of its kind in the U.S.
But structuring itself as a clinically integrated network was fraught with financial, legal and regulatory landmines. Because PCCN would be negotiating contracts with insurers and paying quality-based incentive bonuses to its 1,000 providers, there was inherent risk of inducing referrals and engaging in perceived anti-competitive practices if the arrangements weren’t structured carefully (as famously happened to Danbury Health Systems two decades ago).
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