Report: Integrated Delivery Networks Lack Evidence of Benefits
There is a lack of evidence that integrated care delivery networks produce meaningful benefits, according to a study of large health systems in California and other states, Becker's Infection Control & Clinical Quality reports.
Details of Study
The study was released last week by the National Academy of Social Insurance.
For the study, researchers reviewed publicly available quality and financial data from 15 of the biggest not-for-profit, integrated delivery networks in the U.S., including Sutter Health in Northern California (Barnet, Becker's Infection Control & Clinical Quality, 2/26).
The study was funded in part by the California HealthCare Foundation (NASI release, 2/25). CHCF publishes California Healthline.
The study found that it is possible for integrated delivery networks to offer meaningful benefits, but there is little evidence they have reduced costs or improved the quality of care. Specifically, the report found that:
- The integration of hospitals and physicians has increased costs;
- Shorter lengths of hospital stays and lower charges per admission were not associated with hospital integration into health plan operations and risk-based contracting; and
- Providers are likely to see a decrease in operating margins and return on capital as they invest in integrated delivery networks.
The authors wrote, "If public policy is to continue fostering [integrated delivery network] growth and development, a more solid evidentiary foundation for this form of medical care organization seems essential." They added, "The mere presumption of societal benefits of [integrated delivery network] formation or operations is no longer tenable as a policy principle."
In the report, NASI recommended:
- Improving operating and financial disclosures related to integrated care delivery; and
- Creating a nationwide all-payer claims database (Becker's Infection Control & Clinical Quality, 2/26).