Partners HealthCare: an exercise in marital counseling.

The high cost of health care in Boston led industry and government to expand managed care. The expensive academic health centers had the choice of closing, downsizing, merging, and/or integrating. The MGH and BWH chose to develop Partners HealthCare (PHCS) an integrated healthcare system that maintained the identities of the founding institutions. PHS founded in 1994 is physician-led and protects the missions of patient care, research and education. It includes the MGH and BWH, four community hospitals and one thousand primary care physicians. All administrative services have been consolidated as had several clinical departments, residencies and fellowships. Research coordination has resulted in shared space, grants, industrial partnerships, and a growth in support. Clinical service volumes have surpassed pre-merger levels. Contracts now cover the true costs of care and produce positive operating margins and bottom lines. The strategy of forming an integrated health system has achieved most but not all of its goals.