RESUMEN
This article represents the history of primary care and behavioral health integration at Group Health Cooperative (GHC) over the last decade, and foreshadows probable futures for this work into the next decade. To build from a logical progression, the article responds to a series of questions: 1. Why integrate primary care and behavioral health? 2. What has been done so far and how well has it worked? 3. Keeping the end in mind, what's the idealized picture of integration for the future? 4. How to get from here to there? What will help or hinder the effort? and 5. Again, why make these efforts to integrate?
Asunto(s)
Medicina de la Conducta/historia , Sistemas Prepagos de Salud/historia , Atención Primaria de Salud/historia , Medicina de la Conducta/tendencias , Asignación de Costos , Sistemas de Apoyo a Decisiones Clínicas , Atención a la Salud/organización & administración , Atención a la Salud/tendencias , Prestación Integrada de Atención de Salud/economía , Prestación Integrada de Atención de Salud/organización & administración , Prestación Integrada de Atención de Salud/tendencias , Trastorno Depresivo/terapia , Honorarios y Precios , Predicción , Sistemas Prepagos de Salud/economía , Sistemas Prepagos de Salud/tendencias , Historia del Siglo XX , Humanos , Objetivos Organizacionales , Atención Primaria de Salud/tendencias , Calidad de la Atención de Salud , Resultado del Tratamiento , WashingtónRESUMEN
It's been said that major, landscape-changing events can sometimes stem from the humblest of origins: The gentle flutter of a butterfly's wings, the theory states, can begin a sequence of events that profoundly alters the weather pattern of an entire continent. In the world of science, this phenomenon is known as "chaos theory." But in the dynamic environment of the U.S. health care system--where the HMO philosophy has profoundly alter the way health care is delivered and financed--it has another name: Kaiser Permanente. From the humble yet revolutionary idea of a young surgeon caring for Depression-era workers in the Mojave Desert, to the current 6.7-million-member organization that has served as a model for plan administrators and policy makers across the country, Kaiser Permanente has originated, endured, and contributed more to the health care marketplace over the past 50 years than probably any other entity. Now, on Kaiser Permanente's golden anniversary, as the health plan reflects on its accomplishments and influence, it is plotting a course for quite challenging times ahead.