The organization of heart services. Part Two: Structural alternatives for the successful heart services organization.
This article provides a framework of the various models currently available to form a heart institute that is designed to enhance the position of the providers with managed care and other third-party payers. Each model has components that are similar: Governance and management are provided by an advisory board or steering committee. The board is typically comprised of representatives of both the physicians and the hospital. Daily management is provided by a professional manager, such as an executive director. The ability of the model to locate, negotiate and enter into contracts for the providers is determined by the amount of integration of services provided by the participants. Each of the models discussed in sequence represents increasing integration; therefore, the cardiac IPO has more integration--particularly if it offers a new service such as capitation to the market--than the service-line approach. The ICHO has the most integration of the models presented. This form of organization will be addressed more completely in Part Four of this series. Part Three will discuss PHO models in-depth as well as address certain legal requirements that should be considered when developing a new, integrated PHO entity.
Ronning
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Ronning Management Group, Inc., Mammoth Lakes, CA.
Beveridge
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RN
D002300:Cardiac Care Facilities / Q000458:organization & administration*; D006275:Health Facility Planning; D006759:Hospital-Physician Joint Ventures / Q000145:classification / Q000458:organization & administration*; D008329:Managed Care Programs; D017146:Models, Organizational; D009937:Organizational Objectives; D011357:Product Line Management; D014481:United States