As the healthcare industry continues to experience consolidation and health systems evolve to meet industry challenges, operational integration initiatives present great opportunities to enhance system-wide performance.
Many health systems speak to the integration goals as they design their strategic partnerships, but only a portion develop realistic, achievable, and sustainable integration plans and even fewer accomplish the goals set forth in those plans.
System integration plans fall short and occasionally fail to achieve their desired outcomes most frequently because they lack effective solutions, fail to consider the impact of system operations on the community, and don’t have the necessary support from the workforce. As much as a well-orchestrated integration planning process and an invested leadership team can work to position a system for integration success, a system integration strategy must be grounded in value creation, risk management, and employee engagement to ensure any integration plan to reach its goals.
To achieve success in a value-based world, health systems must actively seek to enhance the value of their clinical services. Defining value as healthcare outcomes per cost, a health system’s pursuit of value creation will involve enhancing the quality of its services while reducing the per unit delivery cost.
Value creation through health system optimization can be achieved through both horizontal and vertical integration strategies. Horizontal integration strategies are focused on reducing unnecessary duplicative resources, enhancing system operational performance, and aligning/optimizing clinical programs and resources. While duplication of select resources and clinical services may be warranted to maintain access in select geographic areas, plans must carefully balance community needs with efficient resource distribution to deliver high-quality cost-effective clinical programs.
Conversely, vertical integration strategies are focused on enhancing the value throughout the continuum of care by effectively positioning access points, redesigning the care model, and promoting information technology and data sharing. As systems form and evolve, seamless handoffs between system providers and multidisciplinary care plans will reduce unnecessary resource utilization and provide for the efficient navigation of patients through the system with high quality and high satisfaction outcomes.
Risk is inherent within every system integration initiative. The term “system integration” can often trigger employment uncertainties and high employee and physician anxiety which heightens the internal challenge to achieve a successful integration. Community resistance or concerns for the planned integration efforts are also possible based upon the drivers that prompted the system to take action. While identified risks may become realities and unanticipated challenges can arise with little warning, effective risk management planning is essential.
Identification and analysis of the integration risks by the system integration leaders and their teams are foundational to the planning process. Balancing the benefits of integration initiatives against the probability of the risk may prompt either the development of preventative and contingency plans, or the abandonment of the integration initiative all together. Regardless, every risk should be thoughtfully analyzed in the context of the benefits of the system integration plan and weighed carefully.
Employee and Physician Engagement
The third pillar to effective health system integration is employee and physician engagement. While system integration planning is overseen and led by senior system leaders, it is imperative that employees and physicians have a voice within the planning process to foster effective integration results.
Solicitation of ideas, involvement in plan development, transparency in the planning process, and frequent communication will provide systems with the best chance for developing an effective integration solution, and fostering acceptance, accountability, and alignment among the stakeholders. This planning approach will also provide the system with the platform to accelerate the change process, and achieve and sustain its integration goals and objectives. While some confidentiality is warranted in the integration planning and implementation process, employee and physician engagement is necessary for success.