# Describe the various types of integrated delivery systems for physicians and hospitals/health systems.
Integrated delivery systems (IDSs) are health care organizations that aim to provide coordinated and comprehensive care to patients across different settings and levels of care. IDSs can vary in their degree of integration, scope of services, ownership structure, and payment arrangements. Some common types of IDSs are:
– **Horizontal integration.** This type of IDS involves the merger or affiliation of hospitals or other acute care facilities that offer similar services and operate in the same geographic area. The main goal of horizontal integration is to achieve economies of scale, increase market share, and enhance bargaining power with payers. An example of a horizontally integrated IDS is Advocate Health Care, which operates 13 hospitals in Illinois .
– **Vertical integration.** This type of IDS involves the linkage of different levels of care, such as primary care, specialty care, hospital care, post-acute care, and ancillary services. The main goal of vertical integration is to improve quality, efficiency, and continuity of care for patients across the care continuum. An example of a vertically integrated IDS is Aurora Health Care, which operates 14 hospitals and 155 clinics in Wisconsin .
– **Physician-hospital organization (PHO).** This type of IDS is a joint venture between physicians and hospitals that allows them to contract with payers as a single entity. The main goal of PHOs is to align the incentives and interests of physicians and hospitals, and to increase their competitiveness in the market. An example of a PHO is Affinity Health System, which is a partnership between Ministry Health Care and Wheaton Franciscan Healthcare in Wisconsin .
– **Accountable care organization (ACO).** This type of IDS is a network of providers that agree to share the responsibility and accountability for the quality, cost, and outcomes of care for a defined population of patients. The main goal of ACOs is to improve value by delivering high-quality care at lower costs, and to receive financial rewards or penalties based on their performance. An example of an ACO is Banner Health Network, which serves more than 300,000 Medicare beneficiaries in Arizona .
– **Payvider.** This type of IDS is a combination of a provider and a payer that offers health insurance plans to its own patients and/or external customers. The main goal of payviders is to reduce financial risks, increase revenues, and enhance patient loyalty. An example of a payvider is Kaiser Permanente, which operates 39 hospitals and more than 700 medical offices in eight states and the District of Columbia .
## References
: 50 Integrated Delivery Systems to Know – Becker’s Hospital Review https://www.beckershospitalreview.com/hospital-physician-relationships/50-integrated-delivery-systems-to-know.html
: Integrated Delivery Networks (IDN) – Health Analytics https://healthanalytics.com/expertise/integrated-delivery-networks-idn/
: A Guide to Physician Integration Models for Sustainable Success https://www.aha.org/ahahret-guides/2012-09-01-guide-physician-integration-models-sustainable-success
: Banner Health Network https://bannerhealthnetwork.com/
: Kaiser Permanente https://about.kaiserpermanente.org/
