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  1. Collaborating Outside the Box : Three Years Later.

    Article - En anglais

    Background :

    In 1992,15 employers in Minneapolis-St Paul, operating as the Business Health Care Action Group (BHCAG), combined their self-insured plans.

    To successfully bid for the BHCAG contract, three competing group practices and a health plan cooperated, operating like a fully integrated care system to measure outcomes, develop practice guidelines, and meet other BHCAG requirements.

    To accomplish this, a new organization, the Institute for Clinical Systems Integration (ICSI), was conceived.

    ICSI in the evolving Minneapolis market-place : From a business standpoint, ICSI members stood to gain market share by being members of ICSI and the « chosen » consortium.

    From a professional standpoint, they could realize the fulfillment and satisfaction of knowing that they were innovating, improving care, reducing waste, and sharing their knowledge with others.

    A new market model : To drive the same kind of change for the entire care delivery system in the region, not just for the subset that happened to win the original bid, BHCAG changed the purchase model in February 1995-enrollees could now choose among 16 to 20 discrete care delivery systems instead of preferentially channeling them to the ICSI-HealthPartners network of group practices.

    All the care systems had become competitors on every level, including quality of care.

    The « special » customer-supplier relationship between BHCAG and the ICSI medical groups was no longer present. (...)

    Mots-clés Pascal : Médecin, Personnel sanitaire, Travailleur social, Pratique professionnelle, Recommandation, A domicile, Soin, Ambulatoire, Politique, Politique sanitaire

    Mots-clés Pascal anglais : Physician, Health staff, Social worker, Professional practice, Recommendation, At home, Care, Ambulatory, Policy, Health policy

    Notice produite par :
    ORS Auvergne - Observatoire Régional de la Santé d'Auvergne

    Code Inist : 002B30A11. Création : 19/02/1999.