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Integrated Delivery Systems In Managed Care

IDSs & Community Accountability


Richard J. Bogue, Ph.D., Senior Director of Governance Programs, Center for Health Care Leadership, American Hospital Association, Chicago, IL.

Dr. Bogue spoke about the principles for holding health plans and integrated delivery systems (IDSs) accountable for their actions being developed by the Coalition for Accountable Managed Care. He also reviewed the vision of the Community Care Network Demonstration Program.

Dr. Bogue believes that comprehensive system change has to take place and that the best way to accomplish that is on the community or local level. He reviewed some ways that policymakers can enable community accountability, such as:

  • Rewarding the community view.
  • Requiring participation by multiple organizations.
  • Encouraging public/private partnerships.
  • Compelling the use of local resources of all types.
  • Developing clearer, broader antitrust guidelines.
  • Improving design of monitoring and reporting mechanisms to maximize effort spent on performance.
  • Evaluating purpose as much as structure or outcome.


American Hospital Association. The 25 Community Care Network Demonstration Partnerships: Profiles in Progress. Hospital Research and Education Trust, December 1996, pp. 1-55.

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