Coordinated care

A reason Kaiser and Geisinger and others have been successful is that they have been able to integrate finacing of care with delivery not just integrating services. In this situation all savings can accrue back to either the delivery system or the health plan so any dollars lost from reducing days per thousand or improving care outputs were replaced with the savings. The problem was that many of these so called IDNs had no real incentive to coordiante care becuase the savings went back to the insurance company not the providers. So many IDNs failed becuase they could not harvest thier savings for being more effective. WJD