Integrated Delivery Networks: A Detour On The Road To Integrated Health Care?

Burns, Lawton R.; Pauly, Mark V.

doi:10.1377/hlthaff.21.4.128

Cited by 214 publications

(199 citation statements)

References 31 publications

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“…Other reported problems are lack of role clarity [9], professional self-interest, competing ideologies, lack of mutual trust, and conflicting views about client interests and roles [10].…”

Section: Cooperation As Ideology and In Realitymentioning

confidence: 99%

Inter-organizational cooperation: A rehabilitation project based on cooperation between health care and three social service agencies

Rudenstam¹,

Holmberg²

2014

Health

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Purpose: Cooperation between organizations is an often-suggested remedy for handling unsolved borderland problems. However, actual projects aiming at cooperation are seldom very successful. The purpose here is to highlight obstacles related to cooperation between different organizations based on a case study of a rehabilitation project where health care and several social service organizations (social insurance, social welfare, and the local employment agency) were involved. Data were gathered through participation and interviews. Findings: It seems that efficient cooperation requires an understanding of the participating organizations' differences in work logic as well as work practices. Furthermore, only certain fairly standardized "normal" problems may be handled through organized cooperation while non-routine exceptional problem requires a more fully integrated work organization. Implications: Obstacles to cooperation are highlighted and ways to improve the possibilities of cooperation between organizations are suggested although such possibilities are generally hampered by differences in work logic.

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“…Other reported problems are lack of role clarity [9], professional self-interest, competing ideologies, lack of mutual trust, and conflicting views about client interests and roles [10].…”

Section: Cooperation As Ideology and In Realitymentioning

confidence: 99%

Inter-organizational cooperation: A rehabilitation project based on cooperation between health care and three social service agencies

Rudenstam¹,

Holmberg²

2014

Health

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“…[48][49][50] So while bundled payments appear to be a future reality, the organizational infrastructure to make it work effectively is largely not in place, and the benefits in terms of producing low-cost quality care are speculative. Therefore, with these caveats in mind, how do these impending changes impact care for the patient with CRC?…”

Section: Health Care Reform and Bundled Paymentsmentioning

confidence: 99%

Biomarkers, Bundled Payments, and Colorectal Cancer Care

Ross¹,

Lynch²,

Raju³

et al. 2012

Genes & Cancer

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Changes in the management of cancers such as colorectal cancer (CRC) are urgently needed, as such cancers continue to be one of the most commonly diagnosed cancers; CRC accounts for 21% of all cancers and is responsible for mortalities second only to lung cancer in the United States. A comprehensive science-driven approach towards markedly improved early detection/screening to efficacious targeted therapeutics with clear diagnostic and prognostic markers is essential. In addition, further changes addressing rising costs, stemming from recent health care reform measures, will be brought about in part by changes in how care is reimbursed. For oncology, the advances in genomics and biomarkers have the potential to define subsets of patients who have a prognosis or response to a particular type of therapy that differs from the mean. Better definition of a cancer's behavior will facilitate developing care plans tailored to the patient. One method under study is episode-based payment or bundling, where one payment is made to a provider organization to cover all expenses associated with a discrete illness episode. Payments will be based on the average cost of care, with providers taking on a risk for overutilization and outliers. For providers to thrive in this environment, they will need to know what care a patient will require and the costs of that care. A science-driven "personalized approach" to cancer care has the potential to produce better outcomes with reductions in the use of ineffectual therapies and costs. This promising scenario is still in the future, but progress is being made, and the shape of things to come for cancer care in the age of genomics is becoming clearer.

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“…Most of these efforts had inadequate resources and weak governance; lacked the clinical discipline and technology capacity to control the use of services or contain expenses; and failed completely. 10 There were a few notable exceptions-such as Geisinger Health System, in Pennsylvania; Intermountain Health Care, in Utah; Aultcare, in Ohio; and the provider system now known as Sanford Health, in South Dakota.…”

Section: Problems With Accountable Care Organizationsmentioning

confidence: 99%

Accountable Care Organizations: The Case For Flexible Partnerships Between Health Plans And Providers

Goldsmith

2011

Health Affairs

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Under the Affordable Care Act, the new Center for Medicare and Medicaid Innovation will guide a number of experimental programs in health care payment and delivery. Among the most ambitious of the reform models is the accountable care organization (ACO), which will offer providers economic rewards if they can reduce Medicare's cost growth in their communities. However, the dismal history of provider-led attempts to manage costs suggests that this program is unlikely to accomplish its objectives. What's more, if ACOs foster more market concentration among providers, they have the potential to shift costs onto private insurers. This paper proposes a more flexible payment model for providers and private insurers that would divide health care services into three categories: long-term, low-intensity primary care; unscheduled care, including unscheduled emergency services; and major clinical interventions that usually involve hospitalization or organized outpatient care. Each category of care would be paid for differently, with each containing different elements of financial risk for the providers. Health plans would then be encouraged to provide logistical and analytic support to providers in managing health costs in these categories.

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Integrated Delivery Networks: A Detour On The Road To Integrated Health Care?

Cited by 214 publications

References 31 publications

Inter-organizational cooperation: A rehabilitation project based on cooperation between health care and three social service agencies

Inter-organizational cooperation: A rehabilitation project based on cooperation between health care and three social service agencies

Biomarkers, Bundled Payments, and Colorectal Cancer Care

Accountable Care Organizations: The Case For Flexible Partnerships Between Health Plans And Providers

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