Abstract
Summary Most American hospitals are now part of multihospital systems, and most physicians are now employed by hospitals or large group practices. Payment for care is slowly shifting from fee-for-service to value-based contracts that encourage a holistic approach to care. These fundamental changes have created complex integrated health care systems that operate under new financial imperatives and have introduced corresponding complexities in all areas: clinical, operational, and financial. Baystate Health is the dominant health delivery system in western Massachusetts and also covers a significant percentage of the population as a payer. Baystate’s CEO discusses how it has created an effective continuum of care through ownership, partnership, and innovative relationships with physicians and how it has addressed the management challenges inherent in integrating an organization that is not just greater than, but also fundamentally different from, the sum of its parts.
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