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MEDICAL PRACTICE MODELS/ INTEGRATED DELIVERY SYSTEMS
This class examines various organizational structures available to physicians and the reasoning behind the creation of such structures. Upon entering the practice of medicine, physicians may choose to associate with a business organization of some sort. This business organization may affect the physician by determining: services to be provided, compensation terms, and long term opportunities. Physicians should understand the different forms of business organizations and how these business organizations effect physicians so that physicians can make an intelligent choice.
This class will look at the advantages and disadvantages of Independent Practice Associations (IPA), Physician Hospital Organizations (PHO), Provider Sponsored Organizations (PSO), Management Service Organizations (MSO), Practice Acquisition models and Equity models. Also, this chapter will explore clinical integration and how it effects physicians.
Class 8 Topics: MEDICAL PRACTICE MODELS/ INTEGRATED DELIVERY SYSTEMS
A. FOUR STAGES OF INTEGRATION AND BUILDING BLOCKS
B. EFFECTIVENESS OF INTEGRATION
II. GOALS OF CLINICAL INTEGRATION
III. FOUR COLLABORATIVE OPTIONS FOR INTEGRATING SERVICES OF HOSPITALS AND PHYSICIANS
A. MANAGEMENT SERVICE ORGANIZATIONS (MSO)
B. PHYSICIAN HOSPITAL ORGANIZATIONS (PHO)
C. PRACTICE ACQUISITION MODELS
D. EQUITY MODELS
IV. INDEPENDENT PRACTICE ASSOCIATIONS (IPA)
V. PROVIDER SPONSORED ORGANIZATIONS (PSO)
Key Objectives
1. Formulate alternatives for healthcare practice models.
2. Identify clinical integration and how it effects physicians.
3. Evaluate emerging models of health care delivery systems and consider the purpose of physician hospital organizations.
Review
1. Describe four collaborative options for integrating services of hospitals and physicians and list the pros and cons for each option.
See: Thomas Bodenheimer, "The American Health Care System - Physicians and the Changing Marketplace," The New England Journal of Medicine (February 18, 1999): 584 - 588.
2. Explain clinical integration, describe its goals, and what it requires to function.
See: Linda T. Kohn, "Organizing and Managing Care in a Changing Health System," HSR: Health Services Research 35:1 Part I (April, 2000): 37 -52
3. Analyze emerging models of health care delivery systems and include listing at least three advantages and disadvantages of physician hospital organizations.
See: Craig E. Holm, "Economic Models for Physician - Health System Partnerships, Journal of Healthcare Management 45:2 (March/ April, 2000): 78 - 81.