Systemness in healthcare: More than the sum of its parts

Since the passing of the Affordable Care Act (ACA), models of Accountable Care Organizations (ACOs), from Pioneer ACOs to Medicare Shared Savings Program ACOs, are under way in some areas of the United States. Physician practice acquisitions, payer/provider partnerships, and patientcentered (or primary care) medical home (PCMH) models are also emerging, but vary geographically. At ECRI Institute’s 19th annual conference, held in Washington, DC, USA, November 28-29, 2012, speakers from integrated delivery systems, military healthcare systems, government, payers, policymakers, and other stakeholders, including patient advocates, discussed these trends in in terms of “systemness,” microcosmic systems within a macrocosmic system. During the conference, titled “Creating Systemness within Healthcare Delivery: Can Success Be Proven and Shared?,” themes of team structures, governance, population health, culture, patient-centered care, and costs and reimbursement emerged.