However, many hospitals are unclear about the differences between these two models — let alone how to decide which is a better option for their organization. Are alignment and integration synonymous? Are they just proxies for employment?
The answer to both questions is no. Alignment and integration are different concepts and require different actions, competencies and cultures.
Alignment is a precursor to integration, for which a group must be blended into a functioning whole. Many clinic-run organizations (e.g., Mayo, Cleveland) and integrated systems (e.g., Kaiser) are examples of integrated groups.
Given its complexity, attaining physician-hospital integration is a lofty and, in some cases, impractical goal for many hospitals. As such, for some organizations, the intermediate step of alignment is the optimal end state, achieving the needed customer value within fixed constraints.
But to align an organization, on which factors should hospitals and physicians focus? Historically, the focus has been on markets: practice locations and patients.
To more effectively align an organization and set the stage for potentially integrating, the collective group should broaden its focus to include additional leadership areas: quality pursuit, operations, strategy and vision in addition to economic alignment, which are both indirect and direct forms of compensation. Coordinating these alignment mechanisms creates a more effective partnership for optimizing care.
Once the collective group is aligned on all these factors, the organization can reevaluate the feasibility and potential benefits of the more complex integration model.
Luke Peterson and Kate Lovrien both work in the health care practice at Kurt Salmon Associates, a health care consulting firm. Learn more about Kurt Salmon Associates.
