Provider organizations have the potential to lead a transformation in how care is provided, at the same time improving quality and patient experience and restraining health care spending. The federal government needs to provide the public with basic protections that ensure that organizations receiving new forms of payment that incentivize efficiency are acting responsibly and not cutting corners. A basic regulatory oversight program needs to be developed that is specific to this unique provider type.
Fortuitously, because integrated provider organizations rely on advanced health information technology, including interoperable electronic health records, oversight can move away from the sometimes counterproductive emphasis on assuring the presence of specified structures and processes to oversight more oriented to outcomes. Regulatory oversight can also assure the public that organizations have adopted and implemented codes of ethics acknowledging the long-accepted professional duty to act in the best interest of clients and avoid conflicts of interest, while also addressing the new expectations that organizations need to prudently manage resources and be accountable for their performance. Regulatory oversight can make sure that the relationships organizations enter into with other components of the health care system are transparent to the public.
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