Advent of "Care Systems" Means Governance Must Also Transform

By Barry S. Bader

Society and industries are always evolving; revolutionary change occurs sporadically when powerful forces align to disrupt the old order. The health care delivery system today is in the midst of an historic transformation to redesign how care is delivered. The quite immodest aim is to take 20 to 30 percent of costs out of the system while maintaining or improving clinical outcomes and patients’ health. A central driver is a shift from volume- and cost-based payment systems, with prices that are opaque to consumers, to value-driven payments and greater transparency of both prices and quality results.

Community-based hospitals are preparing for payment reforms by re-organizing into larger, integrated delivery systems that are economically aligned with physicians and can accept accountability for their costs and quality.

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