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Integrated Delivery System Chapter Summary

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Author Jeff Margolis has spent many years in the information technology industry. He has been a Chief Technology Officer and on the board of directors for various health care companies. He is the founding CEO and Chairman Emeritus of the TriZetto Group, Inc., a supplier of information technology to the U.S. health care industry. The author addresses our complex and somewhat broken health care system from each aspect, then provides his own solution in the form of an Integrated Healthcare Management (IHM) system. With this system, the author believes that health care can be more cost efficient, allow better access to providers, and provide better quality for all Americans.
Chapters 1-7 are the history of how our health care system works. Margolis …show more content…

64). Integrated delivery systems and Accountable Care Organizations (ACOs) will help to meet these two equations. Integrated delivery systems are typically organized in urban or high-density suburban areas containing one or more leading hospitals (p. 66). Many doctors are moving towards being employed by an integrated delivery system or having their practice owned by one. They see the benefit to them and to their patient as everything is all together. A good example of this would be either Kaiser Permanente or …show more content…

Everyone pays the same premium if they exercise and eat right, or sit on the couch and eat junk food all day (p. 145). With value-based benefits, consumers are encouraged to make choices shown to lead to healthier outcomes (p. 145). An example is my employer, UCHealth, using biometric screening. Not only does it help them to know how healthy their population is, and what utilization may occur, but they also give their employees a premium discount.
Value-based provider reimbursements supports and rewards for delivering effective care while discouraging ineffective/inefficient care: capitation, bundling, episodes of care (global billing) and per diem. It rewards physician’s for taking an active role in patient health and pays them for results based on quality not quantity (p. 147-148).
Margolis quotes on page 162 a field study analysis performed on actual claims and experience data from health plans shows that even if basic IHM principals were implemented, it could result in a 10% reduction of total commercial medical costs. If you multiply that by 150 million subscribers to employer-based plans, the projected savings would be $72.7 billion. “IHM will use technology to give patients and doctors share information based on evidence-based medicine, value-based benefits, and value-based provider reimbursements, thereby making the systematic

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