Vertical Integration Delivery System ( Idc )

The seminar that I am leading is the integrated and managed health care systems. One the lessons I’ve learned from watching the documentary “The Good News on American Medicine” is that as doctors we can make a difference in the way we deliver health. That is an important message with all the uncertainty that lie around. That is easier said than done, however. What separate Grand Junction and Seattle and other town mentioned in the video was that the doctors worked collaboratively to ensure low-cost quality care. To accomplish that it means that we must make sacrifices, time and/or monetary, to achieve the same goal.

People open stores for the people who immigrate to seek better wealth. However, the local supply couldn’t provide a diversified market for the local industry, the inelastic demand and high consumption power stimulated the growth of the vertical integration simultaneously. Vertical integration refers to an strategy where a company expand its business operations into several steps but on the same production, in other words, the company owns the distributor/supply chain. What is good about the vertical integration is that vertical integration can help enterprises reduce costs and improve efficiencies by reducing transportation expanses and turnaround time.

Since the establishment of Intermountain Health Care, they have grown to become an internationally recognized system of 22 hospitals, a medical group with more than 185 physician clinics, and an affiliated health insurance company. They have been recognized for their achievements and innovations in the development of systems and management, in order to produce effectiveness and efficiency within the processes of healthcare through high quality services and minimisation of costs. Intermountain Health Care’s performance has proved to be advancing exponentially as of the mid 90s, due to clinical-improvement projects routinely showing significant cost savings.

In today’s time, the hallmark of the US health industry is to form integrated delivery systems. An integrated health delivery system is an arrangement of health professionals and health care facilities that provide health services within a continuous organization of delivery. These systems will allow the purchaser and consumer of health care service to receive all the needed services within a all-in-one delivery system that would facilitate the needed access to the appropriate level of care at the appropriate time (Professional Issues). I.D.S presumably will also provide higher quality services and more patient centric care at relatively lower costs (Effects of Integrated Delivery Systems on Cost and Quality). To best understand integrated delivery systems (IDS), it is helpful to contrast the IDS model with health service delivery under the traditional fee-for-service (FFS) arrangement.

MedStar Union Memorial Hospital (MUMH) is a nonprofit community based hospital and a nationally rank for their specialty performance in nephrology, orthopedics, heart bypass surgeries, knee replacement, general and medical surgery. The hospital is located in north central Baltimore city area and was founded in 1854 by the “Union Protestant Infirmary” to “provide shelter and medical care to the sick, poor, and disabled”. In 1923, the name was change to recognize and honor the people who have contributed to its development and foundation. In 2014, the U.S. News & World Report, MUMH was ranked as the 4th regionally and 4th around the Baltimore metropolitan area and is being recognized among the top 100 of “America’s Best Hospitals” for Intensive Care & Cardiovascular services. The hospital has changed his name around 2012 to MedStar to emphasize its growth strategy as a part of a new brand future. As of July 1st 2015, the median household income was $37,210, poverty level 23.09 %, high school level: 84.4%, bachelor 's degree: 31.7%, graduate or professional degree: 16.6%, unemployed: 12.6% (City Data, 2015). According to the U.S Health News magazine, the hospital is accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF), has 238 beds, estimated 620 physicians, an annual revenue between 100-500 million/year, employees 1,000-5,000 and overall star

Vertical integration – when you choose to produce raw materials and/or distribute finished goods themselves rather than rely on independent suppliers, factors and agents for these tasks

Horizontal integration involves buying out other companies and taking over one single step of an industrial process. It establishes a monopoly because, with horizontal integration, everyone must go the company that has monopolized that step.

Vertical integration is a business growth strategy for economics of scale. It is typified by one firm engaged in different parts of production example; growing raw materials, manufacturing, transporting, marketing, and/or retailing to expand business in existing market for the firm. It can function in two directions both forward integration and backward integration.

Before the late 1800s, a company could be formed with an owner and possibly have family to take over after they died. But if there were no family members, usually the business died out or just ran out of money. During the late 19th century, corporations began to form. Corporations are made up of many people cooperating and they function legally as a person. Vertical integration requires acquiring all means of production. This is a pricey investment, but ultimately has a huge payoff, when you cease to have costs after that. To use horizontal integration, a company must buy all the other companies that produce the same product.

Vertically integrated health care system that I have chosen is the Veterans Administration (VA) it's accountable for a large patient population for military veterans. As stated, The Veterans Health Administration is America’s largest integrated health care system with over 1,700 sites of care, serving 8.76 million Veterans each year (VA.GOV). The services that's provided to veterans is health care, rehabilitation, employment, education, home loan guaranties, and life insurance coverage. VA control costs by buying in bulk and control costs by engaging in a deep, single-source relationship with each patient. The Assistant Secretary for Management oversees all resource requirements, development and implementation of agency performance measures,

In 2004, the Healthcare Effectiveness Data and Information Set (HEDIS) stated that “Kaiser Permanente Southern California (KPSC) region, where approximately 6,000 physicians in the Southern California Permanente Medical Group, and where approximately of 3.5 million adults and pediatric are treated, there performance was below the national 50th percentile”. (Kanter et al., 2013) Since the performance was below what they aspired to achieve, in 2005 KPSC recognized the potential to improve quality of care through providing complete care for patients who have chronic illness.

MedStar Good Samaritan Hospital is a 287 bed, short-term acute care hospital located in Baltimore, Maryland. Founded in 1968 via a donation from a philanthropist, it has approximately 2,000 employees. Good Samaritan has no accreditations but is designated to be a Primary Stroke Center by The Joint Commission ("Healthgrades," 2015). At first glance, it is somewhat surprising that they would have a higher than average readmission rate for stroke patients, however, considering the Stroke Center designation, one must take into consideration that they are seeing a higher than average number of stroke patients. While the national goal for stroke related deaths is 34.8 out of 100,000 admissions, MedStar currently has 48.1 deaths associated with stroke related admissions. This less than desirable performance creates both financial and clinical implications.

West Florida Regional Medical Center (WFRMC) located on the north side of Pensacola, Florida competed strongly with sacred heart and Baptist hospitals for patients. WFRMC’s CEO John Kausch was an active member of the Total Quality Council of the Pensacola Area Chamber of Commerce (PATQC) (McLaughlin, C.P., Johnson, J.K., & Sollecito, 2012).. PATQC’s vision was to develop the Pensacola, Florida area into a total quality community by promoting productivity, quality and economic developments in all area organizations both public and private (McLaughlin, et, al., 2012). John

The vertical integration of J&J into health services was a win-win for the company, employers targeted as customers, and employees (Sarasohn-Kahn, 2008). The expanded growth capability through acquiring companies in the downstream will continue to help the organization offer more products and services. The current problem is that with various product offerings the quality and safety guidelines may have been overlooked. The product recalls have been a result of poor quality management and errors in the manufacturing process. The key benefits of backward vertical integration are: more control over the manufacturing of J&J products, advanced technology, and more trusted industry experience. If J&J has greater control over the upstream (selection of raw materials, production, manufacturing, marketing, and distribution) then greater stability and higher quality goods will be sent to retailers.

In order to ensure successful integration, the organization must ensure that the key players, mainly the physicians, are informed of the benefits to the individual physician, the health care organization, and health care as a whole