GAO Report Finds Integrated Systems Improve Care and Access, but Still Face Challenges

A recent report by the Government Accountability Office suggests that while integrated healthcare systems support patient care and access to care, they still face significant challenges, according to the report.

The GAO study, which stemmed from a directive in the The Health Care Safety Net Act of 2008, examined organizational features of integrated delivery systems and approaches they use to facility access to care for underserved populations as well as challenges the systems face.

The GAO selected a sample of 15 private and public systems that are clinically integrated across primary, specialty and acute care, though they vary in their degree of integration and payor mix.

Some of the strategies found to support the improvement of patient care, include:

•    Electronic health records. EHRs support care coordination, disease management, CPOE and clinical protocols.
•    Operating a health insurance plan. Operating an insurance plan provides resources and increases the availability of data on patients, which can then be used to improve care coordination and disease management.  
•    Employing physicians. Employing physicians helps ensure physician participation in quality improvement efforts.

The report also summarized a variety of tactics used by the systems to improve access to underserved populations, including conducting outreach, providing financial assistance and operating school-based and mobile health centers.

Key challenges for integrated delivery systems were also identified. These include:

•    Not receiving financial reimbursement for the care coordination they provide;
•    Difficulty finding specialty and mental health care services for underserved populations;
•    Not being able to share information from EHRs with outside providers; and
•    Challenges in implementing EHRs.

Read the full GAO report on integrated care delivery for underserved populations.



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