Investigators studied seven integrated health systems to uncover what factors are necessary to encourage disruptive innovations that have the potential to decrease costs while improving quality.
Information technology systems are a prerequisite for integration and performance.
Integrated care delivery is less costly than other methods but varies from market to market.
A strong culture is not sufficient to drive disruptive innovation.
Scarce resources promote innovation.
Patients typically received more care, not less, in the integrated delivery system.
Owning a hospital is not necessary to operating an integrated delivery system.
A small, integrated delivery system—with less than 20,000 members—is viable.
Being big does not intrinsically help an integrated delivery system enter new markets; easy replication is not guaranteed.
The investigators also noted that preventive care did not necessarily lead to healthier patients, as measured by rates of obesity, diabetes and high blood pressure.
"Most health systems are built around acute care and cannot address issues that are really of a civic nature. Public health will need to go beyond disease management to health promotion to make real differences in the state of our health and our nation,” the author concludes.