Determining Options

Health systems and physician groups have a range of options. The tool below displays a range of approaches in terms of degree of integration as well as degree of change in terms of physician autonomy.

Tool: Physician – Health System Alignment Options  

As health systems move from fee-for-service towards value-based payments, their physician relationships tend to move higher on the integration scale displayed in the alignment options tool above. Both employment and clinically integrated networks are increasing rapidly in popularity.

Bundled payments are also common, both through the Center for Medicare and Medicaid Innovation’s bundled payment program and with commercial insurers. For many health systems, bundled payments are a key step along the journey. As one academic center CFO noted, “This allows us to start looking at data and talking costs with our physicians for the first time.” 

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