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Related Experiment Videos

Risk-sharing integration efforts in the hospital sector.

R Jantzen1, P R Loubeau

  • 1Department of Economics, Iona College, New Rochelle, NY, USA.

Health Care Management Review
|June 8, 1999
PubMed
Summary

Most hospitals joined integrated delivery systems (IDSs) by 1996, driven by managed care. Financial risk-sharing decisions depended on managed care, competition, and patient case mix.

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Area of Science:

  • Health Services Research
  • Healthcare Management
  • Hospital Administration

Background:

  • Integrated delivery systems (IDSs) represent a significant shift in healthcare organization.
  • Understanding hospital participation in these systems is crucial for healthcare policy and management.
  • The landscape of hospital networks evolved rapidly in the mid-1990s.

Purpose of the Study:

  • To assess the extent of hospital involvement in integrated delivery systems (IDSs) in 1996.
  • To identify factors influencing hospital participation in IDS networks.
  • To examine the drivers behind financial risk-sharing decisions within these networks.

Main Methods:

  • A national survey of 235 short-term private general hospitals was conducted in 1996.

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  • Data collected focused on network participation and financial arrangements.
  • Statistical analysis was used to identify significant influencing factors.

    • Main Results:

    • Two out of five hospitals participated in IDS networks with financial risk-sharing.
    • An additional third of hospitals were members of IDS networks without financial obligations.
    • Managed care presence was the primary driver for hospitals joining networks.
    • Financial risk-sharing was influenced by managed care, local competition, and inpatient case mix severity.

    Conclusions:

    • Hospital participation in integrated delivery systems was substantial by 1996.
    • Managed care significantly influenced network formation and financial risk-sharing decisions.
    • Local market dynamics and patient acuity also played key roles in strategic network involvement.