Placement: Kaiser Permanente Institute for Health Policy and The Urban Institute
Mentors: Murray N. Ross, Ph.D., Vice President, Kaiser Foundation Health Plan, and Director, Kaiser Permanente Institute for Health Policy; Robert A. Berenson, M.D., Fellow, Health Policy Center, The Urban Institute
Project: Integrated Care Organizations: Best Practices for Organizational Structures and Policy Frameworks to Promote Operational Excellence
Benedikt Simon, Ph.D., is a 2020–21 German Harkness Fellow in Health Care Policy and Practice. As Chief Development Officer, he is one of four managing directors of the MEDIAN Kliniken Group, Germany’s largest provider of post acute and rehabilitative care. In this capacity, Simon is responsible for Medical Strategy and Quality Management, Big Data Strategy, the Digital Team, Mergers and Acquisitions, and the Department of Business Development and Business Excellence. Prior to joining MEDIAN in 2016, he was an Engagement Manager at McKinsey & Company, a role he assumed after five years with the AMEOS hospital group, a private acute care provider. At AMEOS, Simon held various management roles in Switzerland, Austria, and Germany, working in both the ambulatory care sector and acute-care hospitals. He holds a Ph.D. in Medicine (summa cum laude) from the University of Cologne and a master’s degree in Health Economics earned jointly at the University of Cologne and the University of British Columbia, and lectures in Health Policy at the National University of Ireland, Galway.
Project Overview: Health care systems around the world are striving to improve patient outcomes and control costs. Achieving this is complicated, however, when providers do not work in an integrated manner and thus do not have shared accountability for patient outcomes. For this reason, it is essential that care is organized across sectoral borders, between family physicians and acute-care hospitals, or acute-care hospitals and postacute-care clinics. The management and optimization of cross-sectoral patient journeys are, therefore, key points of interest for health care and insurance providers, as well as for policymakers across developed countries.
The overarching aim of this research is to provide insights into how integrated-care organizations achieve optimal cross-sectoral care, and what policies, financial incentives, and governance structures are needed to support this. The first phase of work will include case studies at several Kaiser Permanente sites and other integrated-care organizations across the United States. Interviews with health care leaders and providers will be conducted along with site visits to explore best practices for care integration between primary and secondary care. A second phase of work, to be carried out in collaboration with The Urban Institute, will explore the policies, governance structures, and financial incentives that must be in place for health systems to become integrated-care models.