Six steps to successful network integration.

Some integrated delivery systems have not been successful for a number of reasons. Substantial expenses incurred when initially purchasing physician practices, higher than anticipated operating costs, and a lack of mechanisms whereby physicians can assume leadership roles all may contribute to network failure. As a result, participants in integration efforts are continually modifying their strategies. Implementation of six specific strategies can improve the odds that integrated delivery systems will be successful: placing physicians at risk, enabling physicians to assume leadership roles and be involved in governance, strategically incorporating specialty care, managing group practices as ambulatory care businesses, building a competitive system, and continually redefining the system's strategic focus.