MCOs move toward integrated systems
MCOs move toward integrated systems
Managed care organizations (MCOs) are seeking to become part of integrated delivery systems (IDS), according to a survey by the Managed Care Information Center in Wall Township, NJ.
Roughly 42% of MCOs surveyed said they are part of an IDS. Of those, 35% are integrating vertically, while 19% are integrating horizontally.
In addition, MCOs that offer point of service plans (POS) are more likely to be part of an IDS than those offering HMOs and preferred provider organizations (PPOs), the survey found. Roughly 32% of MCOs that offer a point of service plan are part of an IDS. By comparison, 25.4% of MCOs that offer an HMO and 23% of MCOs that offer a PPO are part of an IDS.
(For the percentage of MCOs integrating vertically vs. those that are integrating horizontally, see chart below.)
An MCO’s profit status has no bearing on integration, the survey found: 23.1% of for-profit MCOs and 23.4% of MCOs reported that they are part of an IDS.
Geographically, the Mountain region boasts the most MCOs in an IDS 24.3%. Surprisingly, only 17.9% of MCOs in the Pacific region reported that they are part of an IDS.
The average number of specialists in an integrated network was 7,871 vs. 6,806 specialists in a non-integrated network. In addition, there were fewer primary care physicians in integrated networks compared to non-integrated networks an average of 7,128 vs. 7, 871, the survey found. And MCOs’ integrated networks had an average of 151 hospitals in their networks compared with 212 hospitals in non-integrated networks.
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