A 58-year-old man needs to have his blood tested on a regular basis so his physician can monitor the effects of the anticoagulant (blood thinner) medication he is currently taking. He usually has his blood drawn at his local lab in San Francisco, California. While traveling on business in Portland, Oregon, he is able to have his blood drawn on the specified day at another LabCorp location. LabCorp operates an extensive network of 1,700 laboratories across the United States, so lab results can be communicated to the patient’s physician from any location.

Geisinger Health System serves an area with 2.6 million people in northeastern and central Pennsylvania. As an integrated health system, it provides coordinated care to meet the wide-ranging needs of patients. The advanced use of information technology has been critical for facilitating communication, reducing duplication of services, and improving the patient experience along the care continuum. Consisting of numerous clinical facilities and a health insurance company, Geisinger Health System offers an innovative approach to care delivery that it hopes will become a national model.

Integration is an organizing principle for care delivery intended to promote better health outcomes and greater clinical and financial accountability. LabCorp’s horizontal integration is a growth strategy that reduces competition from other companies. Geisinger’s vertical integration is a diversification strategy that links a continuum of services to increase the comprehensiveness of care.

In Week 3, you examined the varied services patients may need and researched healthcare organizations that provide those services in your geographic area. In this Discussion, you will examine how integration may affect the delivery of care in your community.

To prepare for this Discussion:

• Review the information related to horizontal and vertical integration in the Resources, including the Shi and Singh (2015) course text, journal articles, and websites.
• Research integrated health systems in your geographic area. If you find that one or more of the settings you identified for your Week 3 Assignment are part of an integrated system, you may further research the setting(s) for this Discussion. If you cannot identify integrated systems close to where you live, expand your search to include other areas in your state. If you are an international student, you may examine a specific geographic area in the United States or research two integrated health systems identified in the Resources.
• Select one vertically integrated health system and one horizontally integrated health system on which to focus for this Discussion.
• Continue researching these two health systems, noting important information about each health system, including its size, settings/locations, and the services it provides. Investigate how the integration of each system has affected, or is expected to affect, issues related to cost, quality, and access to healthcare services in your area. Consider implications of integration for the management of the organization, as well as the patient/consumer experience along the continuum of care.

Post by Day 4 a comprehensive response to the following:

• Describe one vertically integrated health system in your area and share details about its size, settings/locations, and the services it provides.
• Describe one horizontally integrated health system in your area and share details about its size, settings/locations, and the services it provides.
• Explain the potential impact of integration on issues related to cost, quality, and access to care, including implications for the management of the organization and the patient/consumer experience along the continuum of care.

Reminder: Be sure to cite your supporting documentation appropriately in correct APA format.

Readings

• Shi, L., & Singh, D. A. (2015). Delivering health care in America: A systems approach (6th ed.). Burlington, MA: Jones & Bartlett.
  • Chapter 9, “Managed Care and Integrated Organizations” (pp. 361–368)

Select and read two of the following articles in preparation for the Discussion:

• Baker, L. C., Bundorf, M. K., & Kessler, D. P. (2014). Vertical integration: Hospital ownership of physician practices is associated with higher prices and spending. Health Affairs, 33(5), 756–763. 
  Retrieved from the Walden Library databases.
• Cohen, A., Klein, S., & McCarthy, D. (2014). Hill Physicians Medical Group: A market-driven approach to accountable care for commercially insured patients. The Commonwealth Fund. Retrieved from http://www.commonwealthfund.org/~/media/files/publications/case-study/2014/oct/1770_cohen_hill_physicians_aco_case_study.pdf
• Community Catalyst, Inc. (2016). Health Market Consolidation. Retrieved from http://www.communitycatalyst.org/resources/publications/document/Policy-Brief__Health-Market-Consolidation-FINAL-June-2016.pdf
• Cutler, D. M., & Morton, F. S. (2013). Hospitals, market share, and consolidation. JAMA, 310(180), 1964–1970. 
  Retrieved from the Walden Library databases.
• Sanford, K. D. (2013). Integration requires new roles and responsibilities. Healthcare Financial Management, 67(3), 56–60.
  Retrieved from the Walden Library databases.

Use the following resources to learn about integrated health systems. You may find this list helpful as a starting point for identifying health systems in your area on which to focus for the Discussion.