Highlights of the report:
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The total number and size of highly organized health systems continues to grow, supported by M&A activity occurring at relatively the same pace since 2012. HIRC's report, Integrated Delivery Networks: Market Landscape and Strategic Imperatives, provides a market overview of integrated delivery networks, reviews the status of value-based reimbursement, and examines IDNs' most urgent strategic imperatives and operational objectives for 2017. The report addresses the following questions:
- What is the size of the IDN market? How is hospital and physician practice affiliation with large organized systems evolving?
- How are IDNs enhancing the continuity of care across inpatient, outpatient, and post-acute care? Which market trends are impacting IDNs across each care setting?
- What is the landscape of health system-led health plans and ACOs?
- What is the level of IDN participation in Medicare and commercial insurer value-based reimbursement programs?
- What do IDN decision-makers indicate as their most urgent strategic imperatives and operational objectives to address as they adjust to an evolving market landscape?
Key Finding: IDNs continue to expand their exposure to risk-based activities, ranging from participation in ACO arrangements with Medicare and commercial payers to developing their own health insurance offerings.
A Majority of IDNs Report Participation in Payers' Value-based Payment Programs. CMS and commercial payers offer a number of alternative payment model programs as they seek to meet aggressive goals for payments tied to value within the next three years. Over three-quarters of IDNs (79%) report participation in one or more value-based reimbursement programs for Medicare, and over half are participating in commercial payer value-based reimbursement programs.
The full reports examines the landscape of commercial payer payment models and providers' responsibility for drug costs under such contracts.
Population Health Management is a Top Operational Objective for IDNs in 2017. IDNs' top operational objectives are an indication of how they are aligning with and positioning for the transition towards value-based pay. Enhancing population health management programs is most often identified as IDNs' top operational objective, followed by improving the patient experience, improving performance on quality metrics, and expanding access to care.
The full report also examines the top strategic imperatives guiding IDNs' senior management decision-making and provides the following to support IDN account planning:
- IDN Profiles: Detailed profiles for ten select industry-leading integrated delivery networks by captive health plan lives.
- Market Access & Partnership Landscape: Manufacturer ratings of top IDNs' ability to limit brand access and willingness to partner with pharmaceutical firms.
Research Methodology and Report Availability. In December and January, HIRC surveyed 56 IDN senior leaders and pharmacy and medical directors. Online surveys and follow-up telephone interviews were used to gather information. The full report, Integrated Delivery Networks: Market Landscape and Strategic Imperatives is part of the Organized Providers Service, and is now available to subscribers at www.hirc.com.