Lancaster General Health is a nonprofit, community-based health system that serves a catchment area of 1 million residents in Lancaster County, Pennsylvania, and the surrounding five counties. Lancaster General Health is the only health system in this series of case studies that does not own a payor, but it operates as a clinically integrated delivery system with Lancaster General Hospital as its keystone. The medium-sized system includes approximately 700 acute beds at three inpatient facilities and employs nearly 200 physicians.
The case study contains three parts. The first section discusses Lancaster General Health’s history and its decision to dismantle the fully integrated health care system it built in the 1990s. The second section examines Lancaster General Health today, highlighting both innovative practices with disruptive potential and challenges in the absence of an integrated payor. The third section discusses key lessons from the system’s experiences and considers future paths Lancaster General Health may pursue as it continues to strive for innovation.
Disruptive innovations in health care have the potential to decrease costs while improving both the quality and accessibility of care. This is one in a series of Pioneer-funded case studies by the Innosight Institute that uses disruptive innovation theory to examine integrated delivery systems and aims to identify the critical factors necessary to achieve increased quality, reduced cost, and access improvements.