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What Is Integrated Health Care and What Does it Mean for You?

By Dr. Syed Raza, Vice President of Medical Operations, St. Luke’s Health

June 21, 2023 Posted in: Leadership
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Integrated health care is becoming a common term, often used to describe the evolution of traditional care to a more collaborative, inclusive, patient-centered form of care in recent years. Still, many people are unfamiliar with what integrated care really means and, more importantly, how it affects the health care services you and your family may receive.

Defining Integrated Health Care

In a nutshell, integrated health care means clinicians take an approach to care that involves a high level of collaboration within a network of health care partners, allowing them to work together to address all of a patient’s needs, including physical, psychological, social and even spiritual needs. This approach focuses on the whole person, integrating primary care, behavioral and mental health, and specialty care and making it easier for patients to receive all of the services they need to achieve good health. 

Integrated health care involves all members of a health care network, including:

 

The goal of an integrated health system is to provide seamless care, eliminating hassle and inconvenience for patients and allowing doctors and nurses to deliver the highest level of care. A large integrated network that includes multiple health care systems and local community organizations working together to provide compassionate, personalized, evidence-based care, is more likely to give patients a smoother overall experience and greater satisfaction. 

For example, in a traditional health care system, if you were to go and see your primary care physician (PCP) for a health concern and your PCP refers you to a specialist, such as a cardiologist, the process can be time-consuming and tedious. You might need to wait to get an appointment with a cardiologist, who then may order testing that requires preauthorization from your insurance provider. The process could involve having to make multiple phone calls, and it  could take weeks, even months, to receive the care you need depending on a specialist’s availability and other factors.

An integrated health system ideally puts all of your health care resources under the same umbrella, which offers many benefits:

  • Faster, more convenient authorizations

  • Shorter waits for appointments

  • Less hassle for patients

  • More options for referrals 

Integrated Health Leads to Improved Outcomes   

The most important benefit of integrated health is the improved results patients experience. Health care organizations that are part of an integrated network must meet specific quality requirements and practice evidence-based programs. Doctors can then refer a patient to the best specialist and/or hospital within the network that has the skills and expertise to treat the patient’s condition. 

For example, if you go to a cardiologist for chest pains, have tests done and find out you need a heart procedure, the cardiologist can choose the hospital within the integrated network that he or she feels has the best outcomes for that type of procedure. Under traditional health care, this choice is often not possible, as your insurance carrier may provide limited options for where you can receive care.

Integrated care means high-quality care, increasing the likelihood that you will be satisfied with your overall experience. When a patient benefits from a more seamless, smoother process, they are also more likely to develop a higher level of trust with their doctors and nurses. This trust often leads to better adherence to their health care treatment plan and guidance.

St. Luke’s Health is part of a large, longstanding integrated network in Texas, which allows us to:

  • Offer a large number of primary care physicians in many communities

  • Easily refer patients to many different specialties, such as cardiology, pulmonary, gynecology and many other specialists

  • Take the hassle out of seeing multiple doctors

Caring for the Whole Person

Another significant benefit of integrated health is that patients can more easily get the care they need beyond primary and acute care. For example, having access to a larger network of health care hospitals and clinics means you’ll have easier, faster access to specialty services, such as mental and behavioral health. In a traditional health care system, you may have to get preauthorization and wait long periods to get an appointment with a psychologist for your child. An integrated system allows you to focus on what’s most important: the health and well-being of your family.

Overcoming Challenges

Integrated health offers benefits for the clinicians, hospitals and clinics within the network, as well. Those that exist with a large network of hospitals and clinics can often negotiate with insurance companies based on their outcomes. That’s because positive outcomes lead to shorter hospital stays, which encourages insurance companies to negotiate rates with those inside the network. 

While this may cause tension with doctors and other clinicians who are not in the network, it may also motivate hospitals and clinics to improve their services so they are able to join the network. For example, those that fall outside of the network may focus on improving operational efficiency, getting rid of duplicate services and making general improvements.

Although the transition to integrated health can take time, it is becoming more and more common throughout the United States. That’s good news because with such a clear value for patients, doctors and organizations as a whole, the shift to integrated health is likely to continue, providing benefits for you and your family.

 

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