Tom aka Rusty Rustbelt
The Newest “Hot Thing”
As promised, after an eight day swing of health care conferences (speaking and listening) I am back in action. So what is the new hot thing among providers?
Integrated Delivery Systems (IDS)
This is hot, but not really new. IDS became hot in the 90s when it appeared capitation would be the new dominant payment model (capitation failed to catch on for a number of reasons). Many systems use varieties and level of IDS models.
IDS is hot both in anticipation of reform legislation and also because of the economics of medicine. I suspect it will remain hot regardless of whether or not there is reform.
IDS presents in many models, but the key is a central hub (hospital or hospitals) integrating the spokes (physicians, ancillaries) via various methods and structures; affiliation, ownership, networking, etc. The IDS may or may not be linked with an insurance product.
The purpose is better coordination, leading to better care and lower (or slower climbing) costs. In my experience, this works better in larger urban markets than smaller or rural markets, but a lot of really smart people are working on this concept.
Specialists, and especially surgeons, have often been hesitant to embrace IDS structures, seeing only more work and less compensation, offset only by a little less financial risk. I suspect the surgeons will be throwing in the towel and joining up in larger numbers, again, with or without reform.
I have about 1200 pages to read before I make more detailed comments, but this appears to be the wave of the future.