Local physicians and First-Health of the Carolinas are investigating alternative ways to coordinate future services for patients, to ensure improved quality and cost effectiveness.

This is typically referred to as integrated health systems (IHS), which align physician and hospital interests. Such an arrangement would allow physicians to play an even greater role in leadership and governance of FirstHealth.

The decision to study this idea has come about as the result of ongoing talks with the community's doctors that began several months ago, according to FirstHealth.

Combining the efforts of physicians and hospital systems can offer less fragmentation in health-care delivery and ensure that patient care is more timely and efficient, according to a news release from FirstHealth.

The Board of Directors of FirstHealth is leading the feasibility study to determine whether such an approach will work here, along with the financial implications, and the level of interest by physicians and others.

Outside consultants have been hired to assist the board's steering committee, co-chaired by FirstHealth Board Chairman David Burns and Dr. John Ellis, a retired orthopedic surgeon.

They are expected to report their preliminary findings later this year. What happens next will depend upon the consultants' recommendations, the board's actions and the evaluation by local physicians of such an endeavor.

"For any arrangement to be successful, it will need to be patient-centered, performance-driven, and values-based," Ellis said.

Physicians from the medical staffs at Moore Regional in Pinehurst, Richmond Memorial in Rockingham and Montgomery Memorial in Troy have been invited to participate in the evaluation.

"We're having conversations with our medical staff that we've never had before, and it's very exciting to explore how we can improve health care to our community," Ellis said.

Both FirstHealth and physician leaders agree that their patients and the community as a whole could benefit from closer alignment among all organizations. Both have enjoyed a long-standing relationship and have decided to consider taking it to a higher level by investigating the possibility of an IHS, according to FirstHealth.

Regardless of whatever changes might evolve, there will always be a place for independent physicians and practices, health leaders said.

Many health-care experts consider integrated health-care models the best way to improve quality and control cost. Similar integrated systems have already been established in Charlotte, Winston-Salem and Greensboro.

"FirstHealth's decision to look into forming an integrated system is not unusual and is, in fact, quite common across the country," said Charles T. Frock, CEO of FirstHealth of the Carolinas. "Hospital systems and physician offices often see the benefit of aligning their interests to perform better in the marketplace. One of our core values is working together, and this investigation is building on that notion.

"With health-care reform on the agenda for the next president of the U.S., declining reimbursements from our government payers, rising costs and the volatile economy, hospitals and physicians must look at the big picture of health-care delivery and consider that a more cohesive alliance may benefit all the parties involved.

"Beyond providing the best quality care in the region, FirstHealth is committed to its employees and the community [to provide] regular review of options that maximize the success of the organization. As the health care environment continues to change, from technology to medical advances to reimbursement, FirstHealth will remain open and flexible to create alliances with individuals or organizations that share similar goals."

There could be some drawbacks. Carilion Health Systems in the Roanoke Valley of southwestern Virginia created an intergrated health system and has come under fire from some area physicians and patient advocates for its aggressive pricing, according to a story in The Wall Street Journal in August.

The cost of health care is soaring there and health-insurance rates have gone from being the lowest in Virginia to the highest, which is partly attributed to what Carilion charges, according to the WSJ story.

Frock said he doesn't foresee that happening here if such an integrated system were created. He said that Carilion is not a model FirstHealth is considering.

Contact David Sinclair at 693-2462 or by e-mail at dsinclair@thepilot.com.