A quick snapshot of your priorities

• To get us on the same page, how would you summarize your current physician network priorities for the next 12 months? Options: Grow employed network, Improve referral retention, Close specialty gaps, Prepare for value-based contracts, Reduce physician compensation costs, Other
• Tell me which roles on your leadership team must sign off on network strategy decisions. Options: Chief Strategy Officer, VP Physician Enterprise, Chief Medical Officer, Chief Financial Officer, Head of Physician Recruitment, Legal/Compliance, Other
• Walk me through the last time you lost a meaningful referral stream, who noticed it first, and what the immediate impact was.
• How many employed or closely affiliated physicians are in scope for this initiative? Options: <50, 50-199, 200-499, 500-999, 1000+
• Name the functional owner for physician recruitment, and the owner for physician compensation changes.
• Point to the one measurable outcome that, if reached in six months, would make network alignment your team's top priority.

Where referrals actually go

• Imagine your top three referral sources started sending more volume to a competitor, what clinical and financial effects would you see in the first 30 days?
• Which specialties and ZIP code clusters have shown the largest outbound referral drift over the past 24 months? Options: Primary care, Cardiology, Orthopedics, Oncology, Behavioral health, OB/GYN, Neurology, Other specialties, By ZIP code clusters
• Describe how you currently attribute referrals to sites, physicians, and episodes for retention measurement.
• Estimate your annual net revenue loss from referrals that leave your system. Options: <$1M, $1M-$5M, $5M-$20M, >$20M, Unsure
• What single threshold of monthly referral loss in a specialty or region would force you to pause expansion or investments?

Why physicians stay or leave

• Who on your executive team sees physician satisfaction as a primary network risk, and what authority do they have to change incentives?
• Tell me how physicians describe the balance between clinical autonomy and system expectations in your most recent engagement feedback.
• When you last revised compensation or alignment policies, how did referral patterns respond over the following 6 to 12 months?
• Are independent physicians in your service area being actively recruited by competitors right now? Options: Yes, actively, Not currently, Unsure
• If a major physician group insisted on contractual protections to remain aligned, what concession would make you walk away from the proposed network model?

The financial case: what must change

• Which financial target would make a multi-year investment in network alignment a clear yes for your board? Options: Protect 1-3% of referral revenue, Protect 4-7% of referral revenue, Protect 8-12% of referral revenue, Protect 13% or more, Other
• Describe the parts of that target you expect from referral retention, care management savings, and value-based contract upside.
• Estimate one-time implementation costs and ongoing annual run rates you would budget for a six-month pilot. Options: <$250k, $250k-$750k, $750k-$2M, >$2M, Unsure
• Are operating dollars or capital already allocated to network projects this fiscal year? Options: Yes, capital, Yes, operating, Partially allocated, No current allocation, Unsure
• Identify the executive and typical timeline needed to approve an enterprise agreement if a pilot meets the target.

Operational readiness: what could break the rollout

• Imagine a core claims or provider feed is unavailable during go-live, what would fail first and who would be responsible for recovery?
• List the source systems and data owners we must connect to measure referral retention, attributed lives, and total cost of care. Options: EHR / Practice Management, Claims / Payer files, Provider directory, Referral management system, HR / Compensation system, Other
• Name the team or role that controls API access and integration schedules in your environment. Options: Integration Team, IT Engineering, Analytics/Data Team, Vendor Management, Third-party integrator, Other
• Provide your best estimate of data recency, typical cleanliness, and the biggest known gaps.
• Is there any legal, compliance, or executive approval that would prevent data sharing for a pilot? Options: Yes, No, Unsure

The other paths you're weighing

• Pinpoint the top alternative you are most likely to choose instead of partnering with an external network strategy firm, and why.
• List the internal programs or teams that people have proposed to solve recruitment, compensation, governance, or analytics gaps. Options: Grow internal team, Use existing analytics vendor, Extend current EHR contracts, Do nothing, Other
• Provide the names or types of external partners you have evaluated and the stage of each evaluation.
• Under what conditions would you stay with your current approach rather than change, and who would defend that choice internally?
• Has anyone on your team proposed solving this entire program without an outside partner? Options: Yes, formally proposed, Discussed informally, No one has proposed, Unsure

Decision signals that move deals faster

• Pick the single decision criterion that would make you choose a partner today, cost, speed to impact, governance structure, or proven outcomes. Options: Cost, Speed to measurable impact, Governance and physician buy-in, Proven outcomes in similar systems, Ease of data integration, Other
• When do you plan to make a formal decision on network strategy in the next 3 to 6 months? Options: Decision this month, Decision in 1-3 months, Decision in 3-6 months, No planned timeline
• Identify the stakeholders who must approve a commercial agreement and the typical decision order, including legal and procurement.
• State the minimum pilot scale you would accept (physician count, attributed lives, or months) and the single KPI that must be achieved. Options: <50 physicians or 6 months, 50-200 physicians or 6 months, 200+ physicians or 12 months, Unsure
• What would prevent you from signing a full enterprise agreement within 30 days if a pilot met the agreed KPI?

Practical next steps and who to involve

• Before we schedule next steps, what internal barrier should we clear first to avoid losing momentum?
• Select the people we should include in a 60-minute pilot scoping session. Options: Chief Strategy Officer, VP Physician Enterprise, Chief Medical Officer, Head of Physician Recruitment, IT/Integration lead, Analytics lead, Legal/Compliance
• State the target date by which you want a scope and commercial outline on your desk. Options: Within 2 weeks, Within 1 month, Within 2 months, Flexible
• Pinpoint the top three risks to monitor weekly during a pilot and the owner for each.
• Suppose a pilot delivered a 10% improvement in referral retention in six months, what internal approval or remaining condition would still stop you from signing?
• How soon could your team commit a named project owner and two cross-functional participants to a pilot kickoff? Options: Immediately, Within 2 weeks, 1 month, More than one month, Not ready

• Clinical & Economic Solution Experience

• Confirm the current state and its cost to your organization
• You confirm the demonstrated compensation example removes the financial drivers of referral leakage you described.
• Provide anonymized referral counts, productivity items, and current compensation rules for the top 3 prioritized service lines.
• You accept the proposed governance roles and decision criteria as sufficient to operationalize alignment.
• Show the alignment and compensation example applied to your context
• Provide a list of the governance stakeholders and the decision criteria they require for approval.
• Deliver a draft alignment and compensation model calibrated to the provided referral and productivity data before the follow-up session.
• You agree on the analytics view and KPIs that will prove performance under value-based contracts.
• Map governance and decision flows to your stakeholders
• Prove the analytics and KPIs that will show performance under value contracts
• You and the seller align on the remaining evidence and milestone dates required before mutual commit.
• Agree on pilot lines, target KPIs, and a dates-based timeline for pilot measurement and governance checkpoints.
• Forced validation, confirm this maps to your needs
• Decide remaining evidence and next milestones

• Clinical & Economic Solution Experience
• Solution Experience Deck
• Solution Brief — Clinical & Economic Solution Experience

• meeting
• slides
• document

• Develop physician compensation model
• Build network gap analytics dashboard
• Integrate claims and EHR data feeds
• Deploy referral retention dashboard
• Implement provider attribution engine
• Deploy affiliated provider contract templates
• Operationalize pay-for-performance payments
• Launch targeted physician recruitment campaigns
• Establish network governance charter
• Configure clinically integrated network IT stack
• Standardize clinical care pathways
• Migrate provider directory to standard format
• Implement referral management workflow

Develop physician compensation model

• Do you have existing compensation plan documents (base salary schedules, bonus rules, and incentive scorecards) to analyze? Options: Yes, No
• Provide the productivity and performance metrics you want modeled (for example Relative Value Units, panel size, HEDIS measures, patient satisfaction scores). Options: Relative Value Units (RVUs), Panel size, HEDIS/quality measures, Patient satisfaction (CAHPS), Other
• List the provider groups and employment statuses to include in the model (employed physicians, independent contractors, affiliated physicians by specialty).
• Identify the pay components that must be supported (base salary, productivity bonus, quality bonus, on‑call premium, guarantees). Options: Base salary, Productivity bonus, Quality bonus, On‑call premium, Guarantee
• Specify the regulatory or compliance constraints to enforce in the model (Stark law fair market value threshold, Anti‑Kickback considerations, state bonus rules).
• Confirm the acceptance criteria for the compensation model deliverable (for example compliance review completed and modeled provider pay variance ≤5% vs benchmarks). Options: Compliance review completed, Provider pay variance ≤5% vs benchmark, Stakeholder signoff

Build network gap analytics dashboard

• Provide the roster fields you currently have available for providers (NPI, specialty taxonomy, practice addresses, taxonomy codes). Options: NPI, Specialty taxonomies, Practice address, Phone/office hours, Other
• Indicate which payer populations the dashboard must cover (Medicare FFS, Medicaid managed care, Commercial lines, Medicare Advantage). Options: Medicare fee‑for‑service, Medicare Advantage, Medicaid, Commercial
• List the geographic levels required for analysis (ZIP code, county, service area, census tract). Options: ZIP code, County, Service area/defined market, Census tract
• Specify a minimum claims coverage threshold required for gap-analysis to be considered valid (percent of attributed lives with claims feed coverage). Options: >60%, >80%, Custom
• Identify priority specialties to be surfaced as gaps (for example cardiology, gastroenterology, oncology) and any sub‑specialty filters.
• Describe the claims and EHR fields that must appear on the dashboard (CPT, ICD‑10, place of service, rendering NPI, referral destination).

Integrate claims and EHR data feeds

• Do you currently receive X12 837 payer claims files and if so at what cadence (daily, weekly, monthly)? Options: Daily, Weekly, Monthly, Not receiving
• Provide the EHR(s) that will supply clinical data and the interfaces expected (FHIR resources, CCD/CCDA, HL7 v2 ADT).
• Describe the target data latency requirement for each feed type (for example ADT real‑time, claims ≤14 days lag). Options: Real‑time/near real‑time, ≤14 days, ≤30 days, Custom
• Identify the transport and format standards the integration must support (SFTP, MLLP, REST FHIR, X12 / 837). Options: SFTP, REST FHIR, HL7 v2 (MLLP), X12 837
• List the number of unique payer feeds and payer IDs (TINs) planned for phase 1 onboarding. Options: 1‑5, 6‑20, 21+
• Confirm the test acceptance criteria for feed integration (for example 99% schema compliance, ≥95% patient match rate) that will be used for go/no‑go. Options: 99% schema compliance, ≥95% patient match rate, Successful end‑to‑end test transactions

Deploy referral retention dashboard

• Provide the referral flows to monitor (in‑system retention, outbound leakage destinations, referrals by referring NPI). Options: In‑system retention, Outbound leakage by destination, Referrals by PCP NPI, Other
• Describe how referral events are currently captured in your EHR or scheduling system (order type, reason code, referring provider NPI).
• Name the primary owners for weekly referral retention reviews and the expected meeting cadence.
• Indicate whether you require automated attribution of referring NPI to downstream procedure claims within a defined lookback window (for example 12 months). Options: Yes, No
• Select the visualizations required for the dashboard (funnel of referred patients, lost referral destinations, time‑to‑service heatmap). Options: Referral funnel, Lost referral destinations, Time‑to‑service heatmap, Provider comparison
• Provide your current baseline referral retention rate by specialty to configure targets for the dashboard.

Implement provider attribution engine

• State whether you use prospective, retrospective, or hybrid attribution for your value‑based contracts. Options: Prospective, Retrospective, Hybrid
• Identify the attribution rules required (plurality of primary care visits, plurality of allowed professional services, specialty overrides). Options: Plurality of visits, Plurality of allowed professional services, Specialty overrides
• Specify the lookback window for claims history the engine should use for attribution calculations (for example 6, 12, 24 months). Options: 6 months, 12 months, 24 months
• List the patient identifiers to be used for deterministic and probabilistic matching (for example medical record number, Medicare Beneficiary ID, DOB).
• Name the data steward who will manage reconciliation of attributed lives and exceptions during the attribution tuning phase.
• Provide the current count of attributed lives by contract to size the attribution engine and reporting. Options: <5,000, 5,000‑25,000, 25,000+

Deploy affiliated provider contract templates

• Specify whether you require employment agreements, independent contractor templates, or both. Options: Employment agreement, Independent contractor agreement, Both
• List the compensation clauses required in templates (base salary, RVU targets, clawbacks, relocation/loan repayment terms). Options: Base salary, RVU targets, Clawbacks, Relocation/loan repayment
• Describe any state‑level licensure, tax, or workforce laws that alter contract language for specific hires.
• Name the approver or legal contact who will sign off on template language and amendments.
• Indicate the number of specialty‑specific template variations required in phase 1. Options: 1‑3, 4‑10, 10+
• List the compliance checks that must accompany each template (Stark law review, Anti‑Kickback review, fair market value opinion). Options: Stark law review, Anti‑Kickback review, Fair market value opinion, Other

Operationalize pay-for-performance payments

• Identify the quality measure sets to tie to payments (HEDIS, CMS measures, custom ACO metrics). Options: HEDIS, CMS measures, Custom ACO metrics
• Select the payment cadence you prefer for P4P distributions. Options: Quarterly, Biannual, Annual
• Describe the payment methodology desired (withhold, bonus-only, shared savings split) and any thresholds. Options: Withhold, Bonus only, Shared savings split
• List the data sources for performance calculations (claims adjudication files, EHR clinical measures, registry feeds). Options: Claims adjudication files, EHR clinical measures, Registry feeds, Other
• Name the approver and appeals process owner for disputed P4P calculations.
• Explain the reconciliation approach you require for P4P payments (claims‑based reconciliation, chart audit, hybrid). Options: Claims‑based reconciliation, Chart audit, Hybrid

Launch targeted physician recruitment campaigns

• Provide the priority specialties and geographic markets for recruitment in year one.
• Indicate whether recruiting budgets are defined per specialty or centralized. Options: Per specialty budget, Centralized pool, Undecided
• Estimate the number of full‑time equivalent physicians targeted for hire in the first 12 months. Options: 1‑5, 6‑20, 21+
• List approved sourcing channels for outreach (national job boards, locum tenens, academic partnerships). Options: National job boards, Locum tenens firms, Academic affiliations, Other
• Specify the required credentialing timeline from offer acceptance to clinical start date. Options: 30 days, 60 days, 90+ days
• Describe any contract terms that must be included in recruiting offers (non‑compete, relocation assistance, loan repayment).

Establish network governance charter

• Provide the existing governance bodies we should align to (medical executive committee, physician advisory council). Options: Medical executive committee, Physician advisory council, None
• Identify the decision rights to be covered by the charter (clinical pathway approvals, compensation changes, credentialing exceptions). Options: Clinical pathway approvals, Compensation changes, Credentialing exceptions, Other
• Name the voting roles and the quorum rules you expect for governance meetings.
• Specify the cadence for governance meetings and escalation paths to system leadership. Options: Monthly, Quarterly, Ad hoc/escalation
• List the reports the charter must require (monthly referral retention, quality scorecards, financial variance reports). Options: Referral retention report, Quality scorecards, Financial variance reports
• Describe the dispute resolution mechanism you want between employed and affiliated providers (mediation, arbitration, governance review). Options: Mediation, Arbitration, Governance review, Other

Configure clinically integrated network IT stack

• Identify the core systems to integrate (EHR, practice management, payer portals, identity provider). Options: EHR, Practice management, Payer portals, Identity provider
• Specify the analytics hosting preference for CIN dashboards (in‑house data warehouse, cloud BI, third‑party analytics). Options: In‑house data warehouse, Cloud BI platform, Third‑party analytics, Undecided
• Name the single sign‑on or identity provider requirement for user access (for example SAML, OAuth2). Options: SAML/SSO, OAuth2, Other, None
• List the user roles requiring role‑based access to CIN dashboards and which reports each role needs.
• Estimate concurrent user counts for operational dashboards to size infrastructure. Options: <50, 50‑200, 200+
• Provide your audit log and PHI access retention policy in months for the IT stack.

• Master Services Agreement (MSA)
• Statement of Work (SOW)
• Commercial Terms & Order Form
• Performance Milestones & Acceptance Criteria
• Data Processing Agreement (DPA) / HIPAA Business Associate Addendum (BAA)
• Data Sharing & Integration Authorization
• Implementation & Governance Charter
• Change Order Agreement

• Go-live Health Check
• First Measurement Review
• Acceptance Gate Meeting (Day 90)
• Monthly Operational Check-in
• Quarterly Success Review

• Open remediation tickets for operational blockers with target completion dates.
• Capture the buyer's named signatory and record the formal acceptance decision.
• For any conditional or failed criteria, agree remediation actions and a retest timeline.
• Publish the acceptance record with pass/fail status, evidence, and the buyer signatory name.
• Create remediation tickets for any unmet criteria with target retest dates.
• Update the governance schedule to include the retest and any additional monitoring windows.
• KPI trend review
• Ensure specialist referral leakage and provider participation rate are monitored and acted on each month.
• Clear the top operational blockers or assign concrete remediation steps with dates.
• Keep recruitment and coverage plans aligned with operational needs affecting referrals.
• Log new enhancement requests and prioritize them in the shared backlog.
• Re-confirm success criteria and owners
• Validate and correct any data feed issues impacting KPI calculations before the next check-in.
• Executive KPI summary
• Confirm whether referral retention rate and total cost of care PMPM are meeting quarterly expectations.
• Decide on any governance or compensation changes needed to protect referrals and improve performance.
• Agree the top three implementation or enhancement priorities for the coming quarter.
• Publish the quarterly outcomes report with agreed decisions and rationale.
• Open governance change tickets for any compensation or policy adjustments and set implementation dates.
• Schedule targeted follow-ups for any high-risk KPIs with remediation owners and milestones.
• Confirm deployment components and integrations are live or have documented remediation plans.
• Verify early adoption signals are healthy enough to proceed to first measurement.
• Produce a short list of high-priority blockers with resolution dates.
• Publish a deployment validation report summarizing live integrations, outstanding defects, and remediation timelines.
• Create an issues tracker entry for each blocker with a target resolution date.
• Confirm access and training gaps and schedule targeted follow-ups to close them within two weeks.
• Present first outcomes data
• Determine whether referral retention rate and total cost of care PMPM are trending toward the targets in Network Scope & Deliverables.
• Document root causes for each KPI gap with named remediation tasks and dates.
• Confirm a clear timeline and criteria for the acceptance gate meeting.
• Produce a short root-cause analysis for each KPI gap and circulate to stakeholders.
• Record corrective actions with target completion dates in the shared issue tracker.
• Validate data feed completeness and correct any mapping issues affecting KPI calculations.
• Restate acceptance criteria and numeric targets
• Produce a documented acceptance result for each numeric target in Network Scope & Deliverables.
• Open issues and enhancement requests
• Present outcome data against each criterion
• Root-cause diagnosis for gaps
• Deployment and integration validation
• Quality outcomes review
• Early adoption signals and usage patterns
• Cost and contract performance
• Document pass/fail per criterion
• Recruitment and coverage updates
• Agree corrective actions and timelines
• Confirm timeline to acceptance gate
• Open issues, enhancements, and governance changes
• Analytics and reporting health
• Acceptance decision and signatory confirmation
• Blockers and open issues
• Quarter priorities and next steps
• Immediate remediation plan
• Agree remediation plan for any failed or conditional criteria
• Agree operational actions and owners