Integrated healthcare report最新文献

The Twin Cities continues to be an outstanding laboratory for discovering what could be the future in many other markets. Over the last year or two it has been the site of massive consolidation among hospitals, physicians and health plans. Even as the entire infrastructure for healthcare financing and delivery has changed, the state has turned in a good performance in comparison with national cost averages. It is hard to beat premium levels that are 25%-35% lower than national benchmarks. And, these have been achieved by the marketplace, not by government. Nevertheless, employers aren't completely satisfied and the sources of discontent are very instructive. The natural course of market change throughout the country is consolidation from many fragmented competing groups down to a handful of large integrated systems. From an employer/consumer perspective, this natural evolution will reduce competition, concentrate power, eliminate choice, weaken the employer's negotiating leverage, discourage innovation, and reduce the responsiveness and sensitivity to customer service needs. Strategies have to be devised by those engaged in integrated health systems development to counter the perception that consolidation is only an attempt to grab market share. True integration should produce demonstrable improvements in the quality, coordination and delivery of care. But, the trick is understanding the employer and consumer perspective on "improvements". The financing and delivery of healthcare has literally been hidden inside a "black box" for as far back as anyone can remember.(ABSTRACT TRUNCATED AT 250 WORDS)

If you've gotten the message that reengineering is an exercise designed to create profound change, you've gotten the message. If you know from experience that buying a medical group and tacking it onto a hospital or insurance company doesn't create the results you want, you may be starting to understand the importance of reengineering. It isn't easy, but we can't see an alternative. Traditional components of our industry are all on the endangered species list. To us this means making changes in our business processes that are fundamental, radical, dramatic, and process-focused. It means that reengineering must become a way of life.

Before the managed care revolution, we had a costly, fragmented, disjointed, uncoordinated system of healthcare that at one time in our recent history caused the President and his wife to propose massive political reforms. While those reforms were being endlessly debated, the market reformed itself. The electorate reinforced their displeasure over big government by electing a Republican majority in Congress. But, as someone once said, those who forget history are bound to repeat it. At least some of the electorate are forgetting how they originally felt when the Clinton-style big government reforms were rejected. By all accounts, HMOs, integrated health systems, physicians and the general public have a lot to loose, if anti-managed care legislation prevails. The sad fact is that, in states where the issues have been brought to a head, emotions have clearly outpaced facts. Once it hits the "tabloids" it appears that there's no going back. Fears rule actions and the many studies being produced about HMO quality don't seem to make a difference. Perhaps those with the most to lose are the physicians, hospitals and insurers who have gone down that long, difficult and costly road to creating integrated health systems that can actually deliver superior care. The investment in time and talent has been enormous. The existing regulatory hurdles have been steep. Now they face another layer of bureaucracy and complexity in certain states. Given the stakes, it might just be time to fashion "swords into plow shares" as they've done in Colorado. It may beat the alternatives.