Physician-Hospital Integration 2012

How Health Care Reform Is Reshaping California's Delivery System

Camden Group


This is archived content; for historical reference only.

Economic pressures on physicians and hospitals have increased attention on integration and collaboration between providers. The Affordable Care Act (ACA) has also spurred providers to evaluate new models of alignment.

This paper explores the impact of the economy and health reform on physician-hospital integration activity in California. In addition to research findings, the paper presents perspectives from leaders at hospitals, physician groups, health plans, and provider industry associations. Also described are several ACA initiatives that are likely to define, in large part, future integration efforts in California:

  • Health Care Innovation Challenge awards of up to $1 billion in grants to fund innovative service delivery and payment model.
  • Comprehensive Primary Care Initiative offers bonus payments to primary care doctors for improved patient care coordination.
  • FQHC Advanced Primary Care Practice Demonstration tests the effectiveness of Federally Qualified Health Center (FQHC) providers working in teams to improve care coordination for Medicare patients.
  • Bundled Payments for Care Improvement enables provider organizations to receive Medicare payments for specified clinical services in a single payment.
  • Accountable Care Organization allows for legal entities comprised of provider organizations in which primary care physicians use care management processes for Medicare patients.

The paper concludes with case studies on the current and future integration plans of six California provider organizations: Adventist Health, Arrowhead Regional Medical Center, John Muir Health, Presbyterian Intercommunity Hospital, Scripps Health, and the University of California, San Francisco, Medical Center. It also includes discussion of some of the policy implications raised by integration activity.

The complete paper is available as a Document Download.