December 2011 Review – Clinical Integration: Road to Improving Virginia’s Health Care Delivery System

Amidst all the uncertainty and challenges facing the hospital and health system field, there are a few near certainties:

  • Health systems are pursuing greater clinical integration and redesigning care processes to improve quality and efficiency.
  • Payment reforms are coming that will require provider entities to assume more risk: from readmission penalties, to bundled payment options around inpatient stays, to potential episode-of-care models around a particular condition, to accountable care organization-level population health risk.
  • Medicaid budget challenges will continue, and we need to develop delivery system models that can simultaneously improve quality and lower cost trends – otherwise the only policy option available to the Commonwealth will be additional provider rate cuts.

Dec. 2011 Review – Clinical Integration