Horizontal and Vertical Integration of Health Care Providers: A Framework for Understanding Various Provider Organizational Structures
Introduction: Current U.S. policy and payment initiatives aim to encourage health care provider accountability for population health and higher value care, resulting in efforts to integrate providers along the continuum. Providers work together through diverse organizational structures, yet evidence...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Ubiquity Press
2020-01-01
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| Series: | International Journal of Integrated Care |
| Subjects: | |
| Online Access: | https://www.ijic.org/articles/4635 |
| _version_ | 1819082526291918848 |
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| author | Jessica Heeringa Anne Mutti Michael F. Furukawa Amanda Lechner Kristin A. Maurer Eugene Rich |
| author_facet | Jessica Heeringa Anne Mutti Michael F. Furukawa Amanda Lechner Kristin A. Maurer Eugene Rich |
| author_sort | Jessica Heeringa |
| collection | DOAJ |
| description | Introduction: Current U.S. policy and payment initiatives aim to encourage health care provider accountability for population health and higher value care, resulting in efforts to integrate providers along the continuum. Providers work together through diverse organizational structures, yet evidence is limited regarding how to best organize the delivery system to achieve higher value care. Methods: In 2016, we conducted a narrative review of 10 years of literature to identify definitional components of key organizational structures in the United States. A clear accounting of common organizational structures is foundational for understanding the system attributes that are associated with higher value care. Results: We distinguish between structures characterized by the horizontal integration of providers delivering similar services and the vertical integration of providers fulfilling different functions along the care continuum. We characterize these structures in terms of their origins, included providers and services, care management functions, and governance. Conclusions and discussion: Increasingly, U.S. policymakers seek to promote provider integration and coordination. Emerging evidence suggests that organizational structures, composition, and other characteristics influence cost and quality performance. Given current efforts to reform the U.S. delivery system, future research should seek to systematically examine the role of organizational structure in cost and quality outcomes. |
| first_indexed | 2024-12-21T20:18:04Z |
| format | Article |
| id | doaj.art-fafa531cc3a440afa571590e0677106d |
| institution | Directory Open Access Journal |
| issn | 1568-4156 |
| language | English |
| last_indexed | 2024-12-21T20:18:04Z |
| publishDate | 2020-01-01 |
| publisher | Ubiquity Press |
| record_format | Article |
| series | International Journal of Integrated Care |
| spelling | doaj.art-fafa531cc3a440afa571590e0677106d2022-12-21T18:51:34ZengUbiquity PressInternational Journal of Integrated Care1568-41562020-01-0120110.5334/ijic.46354797Horizontal and Vertical Integration of Health Care Providers: A Framework for Understanding Various Provider Organizational StructuresJessica Heeringa0Anne Mutti1Michael F. Furukawa2Amanda Lechner3Kristin A. Maurer4Eugene Rich5Mathematica Policy ResearchMathematica Policy ResearchAgency for Healthcare Research and QualityMathematica Policy ResearchMathematica Policy ResearchMathematica Policy ResearchIntroduction: Current U.S. policy and payment initiatives aim to encourage health care provider accountability for population health and higher value care, resulting in efforts to integrate providers along the continuum. Providers work together through diverse organizational structures, yet evidence is limited regarding how to best organize the delivery system to achieve higher value care. Methods: In 2016, we conducted a narrative review of 10 years of literature to identify definitional components of key organizational structures in the United States. A clear accounting of common organizational structures is foundational for understanding the system attributes that are associated with higher value care. Results: We distinguish between structures characterized by the horizontal integration of providers delivering similar services and the vertical integration of providers fulfilling different functions along the care continuum. We characterize these structures in terms of their origins, included providers and services, care management functions, and governance. Conclusions and discussion: Increasingly, U.S. policymakers seek to promote provider integration and coordination. Emerging evidence suggests that organizational structures, composition, and other characteristics influence cost and quality performance. Given current efforts to reform the U.S. delivery system, future research should seek to systematically examine the role of organizational structure in cost and quality outcomes.https://www.ijic.org/articles/4635vertical integrationhorizontal integrationhealth systemsintegrated care |
| spellingShingle | Jessica Heeringa Anne Mutti Michael F. Furukawa Amanda Lechner Kristin A. Maurer Eugene Rich Horizontal and Vertical Integration of Health Care Providers: A Framework for Understanding Various Provider Organizational Structures International Journal of Integrated Care vertical integration horizontal integration health systems integrated care |
| title | Horizontal and Vertical Integration of Health Care Providers: A Framework for Understanding Various Provider Organizational Structures |
| title_full | Horizontal and Vertical Integration of Health Care Providers: A Framework for Understanding Various Provider Organizational Structures |
| title_fullStr | Horizontal and Vertical Integration of Health Care Providers: A Framework for Understanding Various Provider Organizational Structures |
| title_full_unstemmed | Horizontal and Vertical Integration of Health Care Providers: A Framework for Understanding Various Provider Organizational Structures |
| title_short | Horizontal and Vertical Integration of Health Care Providers: A Framework for Understanding Various Provider Organizational Structures |
| title_sort | horizontal and vertical integration of health care providers a framework for understanding various provider organizational structures |
| topic | vertical integration horizontal integration health systems integrated care |
| url | https://www.ijic.org/articles/4635 |
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