Considerations for Joining the Indiana CIN & Process for Moving Forward - Starling Advisors

Sep 16, 2026

Overview of the Indiana Primary Health Care Association’s plan to advance a clinically integrated network (CIN) following a 2023 feasibility study. Describes workstreams led by an appointed Value-Based Care Steering Committee, including drafting an Operating Agreement and nearing a Participation Agreement. Outlines CIN development across three phases (business case, structuring and governance, implementation) and highlights key questions, commitments, governance tasks, infrastructure needs, and best practices relevant to health centers considering later-year participation.

LanguageEnglish

CategoryPresentations

FormatPDF

Pages21

Reading Time7 min

AccessFree to download

Background

Health Center Network Development

Purpose of the Presentation

Key Considerations

What does it take to be successful?

Network (OACHC) Association (OPCA) Considerations for Joining the Indiana CIN & Process for Moving Forward Indiana Primary Health Care Association June 28, 2024 Copyright, Starling Advisors LLC, 2023. All rights reserved. [www.starlingadvisors.com](www.starlingadvisors.com) 1 Background • In 2023, the IPHCA Board of Directors conducted a feasibility study with HMA analyzing the prospect of developing a clinically integrated network. • The IPHCA Board concluded the feasibility study with the decision to move forward with the next phase of network development, which involves structuring a legal entity to serve as a clinically integrated network. • The Board has appointed a Value-Based Care Steering Committee to oversee this phase of work and worked with Starling Advisors and legal counsel to support the committee in their work. • The committee has successfully drafted an Operating Agreement and is in finishing stages of drafting a Participation Agreement. • The IPHCA Board of Directors will vote to stand up the Clinically Integrated Network in July. • Health Centers will have the opportunity to join the network later this year. Copyright, Starling Advisors LLC, 2023. All rights reserved. Please share freely with anyone who believes everyone deserves access to high quality primary care. Background to Date Recommendations in VBC Steering Committee Executive Summary: • Agreement on the proposal of an LLC legal structure to include both the Indiana Primary Health Care Association and interested health centers tobe Members, with a recommendation to require a financial contribution to be a Member of the LLC. • Focus on the CIN LLC jointly negotiating value-based incentive agreements but allowing the individual health centers to retain control of ratesetting negotiations with payers, which is consistent with the model in other PCA-based CINs. • Creating a governance structure that allows flexibility for additional types or classes of Members or Non-Member Participants, for example, Community Mental Health Centers (CMHCs), which are moving toward Certified Community Behavioral Health Clinics (CCBHC) federal designation, which is consistent with the Missouri PCA-based CIN model of including CMHCs in their CIN. Copyright, Starling Advisors LLC, 2023. All rights reserved. Please share freely with anyone who believes everyone deserves access to high quality primary care. [www.starlingadvisors.com](www.starlingadvisors.com) 3 Health Center Network Development | Phase | Activities | | --- | --- | | 1: Determining if there is a business case and motivation to work together | ü Member engagement – webinar series
ü Value proposition – market trends and network pro forma
ü Legal Structure: Decisions regarding structure and governance
ü Conduct initial meetings with MCOs | | 2: Structuring and answering key questions about what the CIN is and does | ü Develop CIN Operating Agreement
• Develop CIN Participation Agreement
• Facilitation of go/no-go decision
• Facilitate CIN Participation Agreement distribution and collection
• Member commitment-CHC interest assessments | | 3: Implementation and standing up of the CIN | • Assess CHC readiness
• Develop CIN service lines
• Assess existing infrastructure and develop technology and staffing plan
• Build a budget and implement negotiation strategy
• Convene Board and Committees to kick off work | Copyright, Starling Advisors LLC, 2023. All rights reserved. Please share freely with anyone who believes everyone deserves access to high quality primary care. [www.starlingadvisors.com](www.starlingadvisors.com) 4 Purpose of the Presentation • Today’s presentation will help you further understand the opportunity that a statewide Indiana Clinically Integrated Health Center might afford your health center. • We will discuss key considerations for you to contemplate over the next 2 months . • We will discuss the

FAQs

What decision did the IPHCA Board make after the 2023 feasibility study?

The IPHCA Board decided to move forward with the next phase of network development, including structuring a legal entity to serve as a clinically integrated network.

What work has the Value-Based Care Steering Committee completed?

The committee drafted an Operating Agreement and is in the final stages of drafting a Participation Agreement to support the network’s next steps.

What are health centers expected to do if they choose to join a CIN?

Health centers must form or participate in the CIN’s new entity, complete governance-related work, develop and sign required agreements, formally recruit themselves into participation, and design, fund, and implement infrastructure components, standards of performance, and a financial distribution model.

Sep 16, 2026

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