What Are The Benefits Of Integrated Delivery System

Integrated Care Collaboration maintains a health information exchange called the ICare system. Through this system Integrated Care Collaboration has worked towards identifying needs of Central Texas and improving healthcare access to those who need it. Integrated Care collaboration has been nationally recognized and has been accredited with the the Texas Health Information Exchange Accreditation Program (TXHIEAP) and the Direct Trusted Agent Accreditation Program (DTAAP). Both accreditation programs are dedicated to ensuring proper use of HIEs and compliance with federal and state laws as well as HIPAA. Texas Health Information Exchange Accreditation program focuses on proper exchange of patient information while Direct Trusted Agent Accreditation Program is geared toward recognizing excellence in data processing and transactions

Partners HealthCare is a non-profit, health system located in Boston that created a data based transformation (Davenport, 2013). It integrated a new system that aligned the participating organizations to cohesively run as one and to help shape the future of the organization. The system didn’t stop there as it was responsible for bettering the patient financing experience and the delivery of healthcare information to other organizations (Davenport, 2013). The initial goal of the organization was making patient care more affordable and accountable by providing integrated, evidence based, patient-oriented care.

Clinical integration is the overall purpose of an integrated physician model. Clinical integration provides an opportunity to coordinate services through centralized scheduling, electronic health records, clinical pathways, management of chronic diseases, and innovative quality improvement programs (Harrison, 2016). This needs to be a major factor in the planning process. When you have the capability and access to an patients care plan because of greater resources and having all of the necessary silos to provide such care, well then it becomes a much smoother process and as a result this can play a factor into timely care and quality of care, as well it can contribute to cost reducing factors such as outpatient care. The electronic health records allow each silo to have access to treatments and testing that has already been done, this further improves quality, timely, and costly care. The clinical pathways allow creating a standardized care plan for patients that over time become more effective and efficient. The management of chronic diseases before clinical integration could be very costly and painful, requiring the patient to see multiple facilities and doctors with limited communication between the different facilities. With success in clinical integration these patients can have easy access to their providers and information because it would all be tied together, it can reduce the stress of knowing everything themselves because the information would already be

Two organizations migrating to a common health information system would need a system that meets current regulatory requirements, meets the needs of the combined organization and their practice environment. The implementation of a common health information system would require an interdisciplinary group of forward thinking innovators, and an interoperable electronic medical record system that includes standard nursing terminology.

Interoperability is the way information is shared across an organization. Sharing information across all avenues of health care is imperative to quality patient care. Coordination between all members of the health care team can occur through a congruent system, eliminating unnecessary phone calls and paper work that take away from patient care. The sharing of information electronically reduces the likelihood that files could be lost or stolen which creates a liability for all those involved in the care of the patient.

The delivery system reform include: Mandates that the Secretary of Health and Human Services adopt value-based purchasing and payment methods for Medicare reimbursements for both physicians and hospitals. Creates incentives to reduce preventable hospital admissions. Creates a new Center for Medicare and Medicaid Innovation that will research, develop, test, and expand innovative payment and delivery arrangements. Encourages the formation of Accountable Care Organizations (ACOs) that allow hospitals and doctors to work together to manage and coordinate care and provides that these ACOs will receive a share of the savings they achieve for Medicare

Integrated Managed Care Organization- The organization is properly aligned for the primary driver being cost cutting services. Since all entities within the organization are responsible and affected by any expenses endured on any entity being unfavorable or favorable, the foundation serves as a primary motivator to reduce costs at all levels. This alignment eliminates any financial gains from driving high utilization of services or higher intensity services within the organization. Ultimately, this system allows the physician medical group to drive care, being responsible for the clinical care decisions as opposed to health plan making those decisions as designed in other organizations. This is the preferable model for Medicaid systems as

“An Integrated Physician Model is the result of a series of partnership between hospitals and physician develop overtime” (Harrison, 2016). Primarily, it is a joint venture that has become many joint ventures. In addition, all of this joint ventures are connected through congruent goals, and that is to provide different level of care to all the patients. Integrated physician model also organizing themselves to improve the cost and quality by operating under a clinical guideline. This could include acute care hospital, home care, nursing homes, affiliated medical group, primary care clinics, employed physician and any independent medical groups.

Coordinated care is reminiscent of a Health Maintenance Organization (HMO); however, the difference between the two is that an ACO does not have a gatekeeper like HMOs thus patients are free to see whichever provider or specialist accepts his or her insurance. Another key difference between ACOs and traditional hospital and physician payment programs is how they are paid. As mentioned above, healthcare systems are rewarded for coordinated quality care that is not duplicated; essentially, the program rewards health systems for keeping patients out of the hospital. In an ACO, hospitals are fined for readmissions and rewarded for reducing costs and population health. Although that sounds great from a patient’s perspective, it is a huge culture and financial change in the business of healthcare. In a descriptive study performed by Epstein et al., they found, “…no differences in baseline quality between hospitals that participated in an ACO and those that did not…found only modest differences in baseline

Benoff, M. a. (1997). Risk Sharing in an Integrated Delivery System. Healthcare Financial Management, pp

Brailer (2005) acknowledges that a sizeable number of citizens receive treatment from multiple providers at a time. Interoperability is a gateway for many business ventures in healthcare to accommodate for patients being admitted in multiple provider organizations. All healthcare professionals, especially managers, must communicate effectively. A good example of interoperability is transformation of electronic medical records, or recruiting physician specialists to operate on a specific procedure (Hellberg & Gronlund, 2013).

A patient centered medical home (PCMH) could integrate patient care. A patient centered medial home is a team of healthcare providers coming together to improve the health of a specific population. A PCMH is designed to integrate primary care and specialists into improve care coordination, safety and quality.(Stange, et al 2010) A PCMH would also improve physician training and development to provide a commitment to treat the whole patient, rather than just one part.(Stange, et al 2010) Healthcare fragmentation can also be limited through improved communication between providers using e-mail and social media tools such as facebook and twitter.

Horizontal integration is the expanding of a company through increasing the service to create a stronger and more enhanced company that provides the same service. Vertical integration is when a company owned individual providers create or operates the distribution themselves. In order to provide the best healthcare service, healthcare facilities needs to offer a network of providers with a wide range of healthcare service. The term integration delivery system (IDC), “is a network of organizations that provides or arranges to provide a coordinated continuum of services to a defined population” (Shi& Singh, pg. 366). The goal for healthcare organization is to provide high quality and efficiency of care with cost reduction for healthcare aimed toward the patient population. This goal is not only a great benefit for an organization but for patient and also for healthcare services providers.

Managing the growth of allied health care sector in the United State. Healthcare delivery system changings are most effectual when they are cohesive and ensure real answerability from providers to patient to improve outcomes. With the expected increase in allied health staff in the healthcare organizations, the first need will be to ensure that the care provided to patients is not impacted in anyway. Hiring new allied health staff allows organization to provide to provide adequate care for patients, but it also increases the cost to provide care. This means that recovering the financial costs of care and minimizing the cost of care takes a higher priority. Evidence proposes that multiple methods to delivery system changes may be necessary bend the cost curve and improve care quality. For example, the efficiency of a single disease administration program may be limited for patients who have multiple chronic conditions and who require coordinated care from many

The best health care systems in the world offer integrated care. Systems like the Mayo Clinic and Geisinger Health System own hospitals and labs and employ all the physicians and nurses a patient is likely to see, so they can easily integrate a patient’s care. In contrast, patients in North Carolina and throughout America typically obtain their care from a variety of independent providers. Health care expenses are paid by a variety of sources including private insurers, employers, the government and patients themselves. But unlike any other state, or even any large geographic area, North Carolina has the capacity to create a “virtually” integrated system, one that can provide the same integrated care but across an entire state. When patients’ transition between providers and health care settings, the result is often poor health outcomes, medical errors and costly duplication of tests and procedures. Through partnerships with other organizations and providers, NCHQA is seeking ways to better coordinate care and address systemic problems that cause dangerous and costly gaps in care. (NCHQA, 2014)