Health Affairs, 26, no. 4 (2007): w532-w544 (Published online 10 July 2007) doi: 10.1377/hlthaff.26.4.w532 © 2007 by Project HOPE	New Online   Senate Health Reform Bill   Rewarding Providers   Public Option Policy Brief   Health Reform & Abortion   Delivery System Reform

This Article Full Text (HTML) Reprint (PDF) Submit a response to this article Alert me when this article is cited Alert me when Comments are posted Alert me if a correction is posted Services E-mail this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Archive Download to Citation Manager Reprints & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Pham, H. H. Articles by Milstein, A. Search for Related Content PubMed PubMed Citation Articles by Pham, H. H. Articles by Milstein, A. Related Collections Health Reform Hospitals Business Of Health Quality Of Care Health Spending

Web Exclusives

Redesigning Care Delivery In Response To A High-Performance Network: The Virginia Mason Medical Center

We examine how an integrated delivery system responded to threatened exclusion from an insurer’s high-performance network by attempting to reduce costs through fundamental redesign of care processes. Some factors facilitating this transformation, such as its structure as a large salaried medical group exclusively affiliated with a hospital, might be specific to the organization and its market. Other essential elements could be replicated. But in a fee-for-service payment system, cost reduction from reducing the number of services or changing their mix can reduce profitability. Making the business case for sustaining desirable provider behavior may require that purchasers and plans make equally fundamental changes in payment policy.

                      What's this?

This article has been cited by other articles:

				H. H. Ting, K. G. Shojania, V. M. Montori, and E. H. Bradley Quality Improvement: Science and Action Circulation, April 14, 2009; 119(14): 1962 - 1974. [Full Text] [PDF]

				R. E. Mechanic and S. H. Altman Payment Reform Options: Episode Payment Is A Good Place To Start Health Aff., March 1, 2009; 28(2): w262 - w271. [Abstract] [Full Text] [PDF]

				J. C. Robinson Value-Based Purchasing For Medical Devices Health Aff., November 1, 2008; 27(6): 1523 - 1531. [Abstract] [Full Text] [PDF]

				T. C. Rosenthal The Medical Home: Growing Evidence to Support a New Approach to Primary Care J Am Board Fam Med, September 1, 2008; 21(5): 427 - 440. [Abstract] [Full Text] [PDF]

				P. V. Lee and D. Lansky Making Space For Disruption: Putting Patients At The Center Of Health Care Health Aff., September 1, 2008; 27(5): 1345 - 1348. [Abstract] [Full Text] [PDF]

				J. J. Mongan, T. G. Ferris, and T. H. Lee Options for Slowing the Growth of Health Care Costs N. Engl. J. Med., April 3, 2008; 358(14): 1509 - 1514. [Full Text] [PDF]

				R. J. Baron and C. K. Cassel 21st-Century Primary Care: New Physician Roles Need New Payment Models JAMA, April 2, 2008; 299(13): 1595 - 1597. [Full Text] [PDF]

				H. H. Pham and P. B. Ginsburg Unhealthy Trends: The Future Of Physician Services Health Aff., November 1, 2007; 26(6): 1586 - 1598. [Abstract] [Full Text] [PDF]