An integrated delivery system (IDS), also known as integrated delivery network (IDN), is a
health system
Health, according to the World Health Organization, is "a state of complete physical, Mental health, mental and social well-being and not merely the absence of disease and infirmity".World Health Organization. (2006)''Constitution of the World H ...
with a goal of logical integration of the delivery (provision) of
health care
Health care or healthcare is the improvement of health via the prevention, diagnosis, treatment, amelioration or cure of disease, illness, injury, and other physical and mental impairments in people. Health care is delivered by health ...
as opposed to a fragmented system or a disorganized lack of system.
The term has sometimes been used in a broad
sense
A sense is a biological system used by an organism for sensation, the process of gathering information about the world through the detection of stimuli. (For example, in the human body, the brain which is part of the central nervous system rec ...
with reference to
managed care
The term managed care or managed healthcare is used in the United States to describe a group of activities intended to reduce the cost of providing health care and providing American health insurance while improving the quality of that care ("man ...
in general (as opposed to
fee-for-service Fee-for-service (FFS) is a payment model where services are unbundled and paid for separately.
In health care, it gives an incentive for physicians to provide more treatments because payment is dependent on the quantity of care, rather than quality ...
care), but in the United States it now more often refers to any specific network of health care organizations constituting a
corporate group
A corporate group or group of companies is a collection of parent and subsidiary corporations that function as a single economic entity through a common source of control. These types of groups are often managed by an account manager. The concept ...
that attempts to integrate care to some degree (that is, to coordinate the patient journey across
care transitions). Some IDSs have an
HMO component, while others are a network of physicians only, or of
physician
A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...
s and
hospitals. Thus, the term is used broadly to define an organization that provides a continuum of health care services.
Background
The guiding business model and philosophical goal of the IDN is to serve as a self-contained healthcare ecosystem, with the ability to contain the entirety of the patient experience to coordinate care and manage population health. Examples of IDNs include
Highmark Health,
Kaiser Permanente
Kaiser Permanente (; KP), commonly known simply as Kaiser, is an American integrated managed care consortium, based in Oakland, California, United States, founded in 1945 by industrialist Henry J. Kaiser and physician Sidney Garfield. Kaiser ...
,
UPMC,
Mayo Clinic,
Cleveland Clinic
Cleveland Clinic is a nonprofit American academic medical center based in Cleveland, Ohio. Owned and operated by the Cleveland Clinic Foundation, an Ohio nonprofit corporation established in 1921, it runs a 170-acre (69 ha) campus in Cleveland, ...
,
Geisinger Health System
Geisinger Health System (GHS) is a regional health care provider to central, south-central and northeastern Pennsylvania. Headquartered in Danville, Pennsylvania, Geisinger services over 3 million patients in 45 counties.
History
Geisinger is na ...
,
Jefferson Health, and
Intermountain Healthcare
Intermountain Healthcare is a not-for-profit healthcare system and is the largest healthcare provider in the Intermountain West of the United States. Intermountain Healthcare provides ambulatory and acute health services, along with other medic ...
.
Five factors that can be used to assess the advancement level of a particular IDN include provider alignment, continuum of care, regional presence, clinical integration, and reimbursement.
Between 2013 and 2017, healthcare providers created 11 new integrated delivery systems from joint ventures with insurance companies.
Some insurance companies have invested in primary care, particularly
UnitedHealthcare
UnitedHealth Group Incorporated is an American multinational managed healthcare and insurance company based in Minnetonka, Minnesota. It offers health care products and insurance services. UnitedHealth Group is the world's seventh largest c ...
, which runs a provider subsidiary, OptumCare.
Reception
Alain Enthoven
Alain C. Enthoven (born September 10, 1930) is an American economist. He was a Deputy Assistant Secretary of Defense from 1961 to 1965, and from 1965 to 1969, he was the Assistant Secretary of Defense for Systems Analysis. Currently, he is Marriner ...
, the Marriner S. Eccles Professor of Public and Private Management, at the
Stanford University Graduate School of Business, argues that IDSs align incentives and resources better than most healthcare delivery systems, leading to improved medical care quality while controlling costs.
Consolidation among IDNs in the United States has critics who say these networks may actually be trending the cost curve upward. An interview of health insurers regarding Partner's Healthcare proposed acquisition of the Care New England Health System, for example, exposed the trepidation insurers have regarding IDN leverage over payers.
[(Feb. 4, 2018]
“Market Impact Review: Partners HealthCare’s proposed acquisition of the Care New England Health System”
Bailit Health. Retrieved 2019-1-15.
Vendors
*
ICA (HIT)
See also
*
Independent practice association
In the United States, an independent practice association (IPA) is an association of independent physicians, or other organizations that contracts with independent care delivery organizations, and provides services to managed care organizations on ...
*
Management services organization
References
{{reflist
Medical and health organizations based in the United States
Managed care