Public policy has fostered the growth and development of integrated delivery networks for the better part of the last four decades, despite their being very little evidence of their societal benefits, according to a new study from the nonpartisan National Academy of Social Insurance.
Researchers analyzed the publicly available quality and financial information from 15 of the largest nonprofit, integrated delivery networks in the country, including:
- Henry Ford Health System (Detroit)
- North Shore-LIJ Health System (Great Neck, N.Y.)
- Intermountain Healthcare (Salt Lake City)
- Sutter Health in Northern California (Sacramento, Calif.)
- BayCare Health System (Clearwater, Fla.)
- Geisinger Health System (Danville, Pa.)
Highlighted below are several findings from the study:
- Little evidence was found to support the claim that integrating hospital and physicians care has helped promote quality and reduce costs.
- In fact, evidence suggests hospital-physician integration as led to higher physician costs and hospital prices.
- Hospital integration into health plan operations and risked-based contracting was not associated with either shorter lengths of stay or lower charges per admission.
- Evidence indicates that the more providers invest in integrated delivery networks, the lower their operating margins and return on capital.
Despite the study findings, it is still possible that societal benefits of integrated delivery networks exist, according to the study.
"But if they do, given the opacity of present IDN disclosure of key operating information, they eluded us in this preliminary investigation," according to the study. "If public policy is to continue fostering IDN growth and development, a more solid evidentiary foundation for this form of medical care organization seems essential. The mere presumption of societal benefits of IDN formation or operations is no longer tenable as a policy principle."
The National Academy of Social Insurance included several recommendations for integrated delivery networks in its study, including improved operating and financial disclosures and creating a national all-payer claims database.
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