Clinically Integrated Networks (CINs) offer a practical pathway for states seeking to strengthen care delivery, improve coordination and support long-term sustainability—particularly in rural and under-resourced communities. As health care systems face increasing pressure to deliver higher-quality care at lower cost, many providers lack the scale, infrastructure and resources needed to participate effectively in value-based models. CINs enable independent providers to collaborate through shared data, standardized clinical protocols and coordinated care management while maintaining local governance.
Across state-led transformation efforts, including the Rural Health Transformation Program (RHTP), there is a consistent emphasis on building the foundational elements that support clinical integration. While not always explicitly framed as CIN development, these efforts reflect a broader shift toward integrated, population-focused models of care.
This playbook provides a framework for states to support the development and maturation of CINs. It outlines core components of CINs, including governance, data infrastructure, care coordination and contracting readiness, and presents a set of actionable strategies states can use to convene stakeholders, structure funding and align policy and payment approaches. The playbook also introduces tools such as a minimum standards checklist and a maturity pathway to help states assess readiness and guide investment decisions.
CINs enable rural providers to coordinate care across regions, reducing variations in treatment and administrative burdens through standardized pathways and centralized reporting. They support value-based care readiness by pooling data for population health insights and care transitions, improving outcomes like readmission rates while preserving long term financial sustainability. By aligning infrastructure investments, policy strategies and payment models, states can move beyond fragmented, time-limited initiatives and support the development of durable, provider-led networks that improve care delivery and sustain access over time.