1. What do the New Health Care Structures Means for Health Care Ethics? Philip Boyle, STL, Ph.D VP, Mission & Ethics

2. My plan New Structures Continuum and hand-offs (LTC, home health, PACE, hospice) CINs & ACOs Partnerships Physicians Common mechanisms Facilitation Education Policies Moral Problems

3. New Structures Continuum & hand-offs LTC Home health & hospice PACE Programs CINs & ACOs Partners- Walmart, CVS, Walgreens Physicians

4. Clinically Integrated Networks A mechanism for addressing population health management ; infrastructure A contractual agreement between insurance provider and a network of health care providers Health Systems Employed Physicians Independent Physicians Members share the risk in caring for an assigned group of patients (covered lives) across the continuum of care Addresses Triple Aim: 1) improving quality/satisfaction of care experience, 2) improving health of populations, 3) reducing per capita health costs

5. Methods to address Facilitation How to access? Who possesses competencies? Education Problems specific to setting Delivery methods: Web & virtual ECs Policy Specific policy: e.g., smoker & oxygen

6. Content Allocation & appropriate care Population health Consumerism Conflicts of interest Cooperation