Monday, January 14, 2008

Are Integrated Delivery Systems really all that?

Speaking of population-based health care, how about those Integrated Delivery Systems (IDS)? Their fans fawn over IDS’ aggregation of healthcare services in an efficient, social-mission minded, mutually supportive panoply of consumer-friendly, one-stop primary, secondary, tertiary and quaternary and insurance for the cure and coverage of whatever ails all persons or populations. They do have a lot going for them.

Hm. Are they really all that?

So, knowing that a crippling writers’ strike is on the verge of turning much of our popular media from eye-candy to a yawnfest, I’ve decided try to help out. Here is my “Top-Ten” list of why IDS’ could always remain the health care solution of the future:

10 Indisputably better patient safety and health care quality at the same or lower price?

9 Liberal policy wonks like them.

8 Stultifying miasmic bloats of overlapping mid-level Assistant, Associate, Senior and Executive VPs, Directors and Managers. Check out this redacted/altered press release from a household-name IDS

“….has been named (title) for hospital operations and support services across the (institution) campus and outlying medical office buildings with responsibilities including working closely with (others) in the planning, coordination and execution of operational strategies to improve quality, service and financial performance at (Name) in (Region). ….will be the senior administrative officer responsible for materials management, facilities, radiology, anesthesiology, laboratory, perioperative/surgery, patient care services, and ambulatory care.”

7 Go ahead, try to close that stand-alone, major employer, community-based Hugh G. Deficit Memorial Hospital.

6 Um, what does IDS stand for again? A lot of my physician friends have idea none.

5 Its share of black eyes. Oops!

4 And just how are they different than the for-profits?

3 Reverting back to “eat what you kill” physician compensation means "why not keep what you kill" physician compensation.

2 “We discussed management’s preference vs. the doc’s preference and decided to compromise. We’ll do it management’s way.”

1 And the majority of exciting, cutting edge innovations in P4P, insurance benefit design, disease management, the Medical Home and the EHR are mostly coming from where?

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