Those who are rushing pell-mell to develop integrated delivery networks may now wish to pause-if only briefly.The strains of a new tune are drifting across the landscape. They're interrupting the sympho ny of consensus among industry leaders regarding the need for regionally based networks of hospitals and physicians to gain leverage in contracting with insurers.At last month's American College of Healthcare Executives' Congress o n Healthcare Management in Chicago, futurist Ian Morrison called the vertical integration of hospitals, physicians and health plans "the grand illusion of American healthcare." The only ones benefiting from the idea, he warned, a re the healthcare consultants who are peddling it. These words probably struck fear in the hearts of some in attendance.Charles S. Ricks, president and chief executive officer of Atlantic Adventist Healthcare Corp., argues that as managed care becomes increasingly payer-driven, provider networks no longer will be needed. Insurers, he says, can simply offer a deal and hospitals are forced to take it or leave it, network or no.Some financially healthy institut ions agree, and they're telling industry matchmakers to "bug off!"-at least for now. These contrarians include University of Alabama Hospital in Birmingham and University Medical Center in Lubbock, Texas, as well as University of Missouri Hospitals, which pulled the plug on its ill-fated joint venture with Tenet Healthcare Corp. late last year.These institutions generally can fall back on some form of taxpayer support and on their large, complex constituen cies that may not readily buy into the integrated network vision.Still others are seeking a middle ground. In MODERN HEALTHCARE's March 18 cover story, Karen Pallarito described efforts to create virtual healthcare systems, which t ie together all-star components of healthcare delivery through powerful information systems that allow each component to share data and knowledge but retain more of its capital-and its identity.You have to admire institutions that believe they can make it on their own, as long as the decision isn't simply a way to cling to the status quo. At the very least they are buying time to decide whether they want to follow the pack strategy.Successful solo institutio ns must have the courage to take a kick-butt approach to their competitors and the willingness to truly work to meet the needs of their communities. The payoff can be both the sweet music of prosperity and control of one's destiny.
EDITORIALS;STAND-ALONE PROVIDERS PROVE INTEGRATION ISN'T A NECESSITY
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