Health systems have invested significant resources in forming clinically integrated networks (CINs). However, many are struggling to achieve optimal financial performance and an adequate return on these investments. While the first step for any CIN is a candid assessment of their performance and the implementation of best practices, they must manage expenses and enhance revenue to achieve financial success. In working with more than 40 CINs to build or repair their operating models, we have learned that having effective physician-led governance, holistic expense and revenue management, and aligned contracting strategies are critical keys to success. Premier's Joe Damore and Tony Malcoun explain.