Integrating efficiency. Verispan's annual ranking of the top integrated health networks shows improved operating margins along with expanded services.

T he nation’s best performing healthcare systems continue to improve efficiency and have the bottom lines to show it, judging from results of a yearly survey of integrated health networks. Improved occupancy, well-integrated information systems and strong margins marked the results for the 11th annual ranking of health system efficiency and performance by Yardley, Pa.based Verispan, a healthcare data and consulting firm. The ranking comprises the 100 most integrated networks out of more than 580 health systems that are graded on operations, quality, scope of services and efficiency. Criteria changed slightly this year to require a greater number of services for the networks, such as stroke centers, to demonstrate comprehensive care. Subhash Seelam, Verispan’s senior market manager for acute-care networks and contract administration, says networks are relentlessly trying to cut costs and eliminate waste to improve access. More than half, 54%, of the top 100 improved scores by better managing occupancy rates and by adjusting staffing to meet fluctuating demand. “They are trying to optimize their resources,” he says. Roughly onefourth of the top 100 scored the maximum points for information system integration, he says. Of the roughly 580 systems surveyed, 20% reported operating margins of 10% or more. In the top 100, a little more than one in four posted double-digit margins, Seelam says. This year’s three highest-ranked systems did not change from 2007—but their order did. ProMedica Health System claimed the top spot after placing No. 3 in 2007. The seven-hospital, Toledo, Ohio-based system ousted last year’s No. 1, St. John’s Health System, Springfield, Mo., with a score of 93.7 on a 100-point scale. St. John’s, a six-hospital subsidiary of the Sisters of Mercy Health System based in Chesterfield, Mo., ranked No. 3 with a score of 92.03. Once again, Intermountain Healthcare, an 18-hospital system based in Salt Lake City, placed No. 2 this year with a score of 92.72. That’s not to say this year’s overall results didn’t show some volatility. Ten systems that ranked among the top 50 most integrated networks in 2007 experienced a drop of at least 20 spots, including four in last year’s top 20. Presbyterian Healthcare Services, Albuquerque, fell to No. 30 from No. 4. Wheaton Franciscan Healthcare, Glendale, Wis., dropped to No. 84 from No. 12. Health First, Rockledge, Fla., ranked No. 45, down from No. 15 a year earlier. Sharp HealthCare, San Diego, landed at No. 51 after placing at No. 18 last year. Seventeen new systems landed on this year’s list compared with the 2007 ranking. Meanwhile, 13 systems included in last year’s rankings rose in the ranking by at least 20 spots. Bon Secours Richmond (Va.) Health System jumped to No. 23 this year from No. 68 in 2007. The four-hospital subsidiary of Bon Secours Health System, Marriottsville, Md., has invested in technology integration and expanded services in the past two years. The Richmond system has steadily expanded its employment of primary-care physicians and specialists during the past 18 months, a growth strategy Chief Executive Officer Peter Bernard says will continue. The Richmond system’s network includes roughly 115 doctors. Efforts to prepare Melanie Evans