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 and social well-being and not merely the absence of disease and infirmity".World Health Organization. (2006)''Constitution of the World Health Organiza ...

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 profe ...

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 Stimulus (physiology), stimuli. (For example, in the human body, the brain which is part of the cen ...

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 concep ...

that attempts to integrate care to some degree (that is, to coordinate the patient journey across

care transition Transitional care refers to the coordination and continuity of health care during a movement from one healthcare setting to either another or to home, called care transition, between health care practitioners and settings as their condition and car ...

s). Some IDSs have an

HMO In the United States, a health maintenance organization (HMO) is a medical insurance group that provides health services for a fixed annual fee. It is an organization that provides or arranges managed care for health insurance, self-funded heal ...

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

hospital A hospital is a health care institution providing patient treatment with specialized health science and auxiliary healthcare staff and medical equipment. The best-known type of hospital is the general hospital, which typically has an emerge ...

s. 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 P ...

, UPMC,

Mayo Clinic The Mayo Clinic () is a nonprofit American academic medical center focused on integrated health care, education, and research. It employs over 4,500 physicians and scientists, along with another 58,400 administrative and allied health staff, ...

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 Thomas Jefferson University Hospitals Inc, branded as Jefferson Health, is a multi-state non-profit health system whose flagship hospital is Thomas Jefferson University Hospital in Center City, Philadelphia. The health system's hospitals serve ...

, 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 medi ...

. 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, the Marriner S. Eccles Professor of Public and Private Management, at the

Stanford University Stanford University, officially Leland Stanford Junior University, is a private research university in Stanford, California. The campus occupies , among the largest in the United States, and enrolls over 17,000 students. Stanford is consider ...

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)

References

{{reflist Medical and health organizations based in the United States Managed care

Background

Reception

Vendors

See also

References