Clinical integration and new options for academic medical institutions in network development

The author outlines two options, made possible by developments in antitrust law, that can create a favored role for academic health science centers as well as for stand-alone medical schools and teaching hospitals, using the unique strengths of these institutions that are often considered weaknesses by the marketplace. The first option is the development of clinically inte grated collaborations that need not be either system wide or necessarily go verned by total quality management processes, or involve the characteristic s of ownership typical of the usual integrated delivery systems. The second option is the development of new clinical "products." Each option encourag es creative financing, legal, medical, and governance approaches and makes it possible for centers, medical schools, and teaching hospitals to build m ulti-provider collaborations that:are in harmony with their missions and di fferent from the less-compatible integrated delivery systems that they-ofte n seek to build. The author provides an extensive background on antitrust law to explain the two options and: the criteria or; crafting-them within antitrust law. He-t hen describes how antitrust law applies to multi-provider: networks and-in particular to academic hearth science centers and freestanding medical scho ols and teaching hospitals, and gives examples of:the kinds of fruitful col laborations these institutions: could engage int He urges those institution s to realize that if they keep faith with the best characteristics in creat ive new ways (such-as those suggested by his article), they will thrive In years ahead.