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Related Experiment Videos

Do IDSs really benefit from affiliating with managed care plans?

K Hogan1, M Thomopoulos

  • 1SMG Marketing Group, Chicago, IL, USA.

Healthcare Financial Management : Journal of the Healthcare Financial Management Association
|January 7, 1998
PubMed
Summary

Integrated delivery systems (IDSs) gain advantages by owning health maintenance organizations (HMOs), improving care and lowering costs. This trend blurs provider-payer lines and enhances vertical integration for IDSs.

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Area of Science:

  • Healthcare Management
  • Health Economics
  • Health Services Research

Background:

  • Integrated delivery systems (IDSs) often affiliate with health maintenance organizations (HMOs) to access managed care patients.
  • Ownership of an HMO by an IDS offers significant strategic and operational advantages.

Purpose of the Study:

  • To examine the strategic advantages and implications of integrated delivery systems (IDSs) owning health maintenance organizations (HMOs).
  • To analyze the trend of blurring lines between healthcare providers and payers through IDS-HMO ownership.

Main Methods:

  • Analysis of current trends in healthcare organizational structures.
  • Review of data on vertical integration in IDSs with and without HMO components.

Main Results:

Related Experiment Videos

  • IDS ownership of HMOs facilitates a more seamless care process, improved patient outcomes, and cost reductions.
  • IDSs owning HMOs demonstrate higher levels of vertical integration compared to those without HMO components.
  • Legislative changes in some states permit IDSs to operate as insurers, encouraging this integration.

Conclusions:

  • The ownership of HMOs by IDSs is a key strategy for achieving vertical integration in healthcare.
  • The integration of providers and payers through IDS-HMO models is a significant trend reshaping the healthcare landscape.