What is Clinical Integration

Clinical integration is defined as “an active and ongoing program to evaluate and modify the practice patterns of a physician network’s participants in order to create a high degree of interdependence and cooperation among the physician members.” (1)

1. Department of Justice and Federal Trade Commission (1996) Statement 8: Enforcement Policy on Physician Network Joint Ventures. Statement of Antitrust Enforcement Policy in Healthcare.

The overarching (fundamental, integral, intrinsic) goal of clinical integration is to consistently improve the quality of care provided to patients while managing the cost of the healthcare services provided.

GSQN’s clinical integration program is a proactive, physician run and physician lead effort focusing on:

  • Creating a virtual system of care monitoring patients as they move through the inpatient, outpatient, and physician office settings;
  • Use of population health management and analytics technology to identify evidence-based gaps in care, utilization of medical services and care opportunities to benefit our patients
  • Working directly with primary care providers to disseminate the data and create work flows to improve efficiencies with patient care
  • Holding each other accountable to the initiatives of the network
  • Collaborating with employers and health plans to develop contractual and incentive payment arrangements balancing the goals of cost, quality and network integrity.

General Practice


  • Increases ability to recruit and retain physicians within the community
  • Improved community health
  • Increased value-based competition


  • Access to a high quality provider network
  • Higher quality care
  • Increased value for healthcare dollars spent
  • Better coordinated care


  • Containment of health benefits expenses
  • Decreased absenteeism
  • Increased workforce productivity
  • Increased employee health
  • Increased value for healthcare dollars spent


  • Support in monitoring and improving performance on quality measures
  • Access to a high quality referral network
  • Access to a holistic view of individual patients across their continuum of care
  • Insight to claims based data
  • Increased ability to identify and address gaps in care and provide patient outreach
  • Opportunity to earn financial incentives and shared savings by meeting the quality measures and budgets set by the network’s value based payor contracts

Health Plans

  • Access to a high quality network of physicians
  • Higher subscriber satisfaction
  • Increased compliance with HEDIS measures
  • Increased value for healthcare dollars spent
  • Savings from physician led cost containment and utilization programs


  • Ability to address cost and utilization across episodes of care
  • Ability to align provider and hospital quality and safety efforts
  • Ability to curb escalation of self-funded healthcare benefits expense
  • Ability to recruit and retain providers