Integrated delivery systems: the Edsel of health care

Integrated delivery systems (IDSs) describe the various pieces of the provider world that have been pulled together contractually under one corporate roof, forming a single, relatively complete local delivery system to assume risk. Technically, the earliest examples of an IDS are HMOs themselves, be they IPA, staff, or group models. However, an HMO was not called an IDS then, because it was the risk-bearing entity. Integrated delivery systems really emerged over the last few years as HMOs changed from being the risk-bearing entity, to contracting with separate risk-bearing entities.