EP402: What Physicians Trying to Clinically Integrate Care in the Real World Need to Know, With Amy Scanlan, MD

Standing up a clinically integrated network (CIN) is one thing on a slide deck and another thing entirely in the messy middle of an actual physician practice's day-to-day operations. In this episode, Stacey Richter talks with Amy Scanlan, MD, chief medical officer of the new CIN joint venture between UCHealth and Intermountain Health in Colorado's Front Range — a physician-led network of more than 700 primary care providers. Dr. Scanlan digs into what it actually takes to help practices at very different points in their value-based care journey navigate the transition without losing physicians' trust or overwhelming their teams.

WHAT YOU'LL LEARN

✅ Why giving practices the tools they actually need — not the tools leadership assumes they need — requires genuinely listening to physicians first, not just rolling out a standard playbook

✅ What Dr. Scanlan means by the "in-between spaces": the time between appointments where data, technology, and a behind-the-scenes team determine whether patients actually get the care they need

✅ Why medical culture has to shift toward functional, collaborative teams — and why team-based care done badly, as Dr. Scanlan puts it, is "really just a series of handoffs," which is exactly when patients are most at risk

✅ Why value-based, integrated care requires thinking as much about the patients who don't show up for appointments as the ones who do — a much bigger mindset shift than it sounds

✅ Why physician burnout, in Dr. Scanlan's view, is actually a hopeful sign: proof that most physicians still care deeply about doing right by patients, even inside a system working against them

WHY THIS MATTERS

"Physicians are the backbone of this system," Dr. Scanlan says — and Stacey frames the stakes even more bluntly beforehand: healthcare businesses need infrastructure, data, and teams to succeed under value-based payment, and that costs real money, which raises the uncomfortable question of how much profit is too much before "doing well" tips into "financial toxicity." Getting clinical integration right isn't just an operational challenge; it's about whether physicians can lead this transformation on terms that still put patients first.

MENTIONED IN THIS EPISODE

Article: "Doctors Aren't Burned Out From Overwork. We're Demoralized by Our Health System." by Eric Reinhart, MD, PhD (New York Times)

EP393 with David Muhlestein, PhD, JD: Apple Podcasts | Spotify | Other Apps

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🔗 Show Notes with all mentioned links: Episode Page

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00:00 Introduction.

06:33 How is Dr. Scanlan thinking about the transformation process and the shift to value?

09:14 "It is really trying to think about, how do we help practices get there?"

11:46 "The hard part is the in-between spaces."

14:10 "Team-based care done badly is really just a series of handoffs."

15:50 "We have to get to that point where the culture of collaboration is more pervasive."

19:57 "How do we as healthcare providers step in and solve this problem?"

20:04 Why do providers have a responsibility to step in and try to fix the healthcare system?

21:50 Why do physicians need to be accountable for the cost of care as well as outcomes?

23:37 Why does physician burnout give Dr. Scanlan hope?

24:25 What is the solution to changing fee-for-service incentives?

25:42 What are some of the challenges facing changing incentives?

27:14 Why is data so important?

30:11 "It's important to understand that we are in the middle of this change."

31:16 Dr. Scanlan's advice for those trying to stand up a CIN.