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The Design and Acceleration of Healthcare Reform/ACOs: The Fairview Medical Group Case

Reconfiguring the Ecosystem for Sustainable Healthcare

ISBN: 978-1-78441-035-3, eISBN: 978-1-78441-034-6

Publication date: 12 August 2014



This chapter integrates organization design and sustainability concepts to describe an accelerated transformational change at the Fairview Medical Group (United States).


A case study of the transformation at Fairview Medical Group’s primary care clinics was developed from interviews and first-person accounts of the change. Objective data regarding outcomes was used to evaluate the effectiveness of the redesign process.


The Fairview Medical Group developed an innovation and change capability to transform 35 primary care clinics in six months. All of the clinics were certified by the state of Minnesota as complying with their healthcare standards. Clinical outcomes, costs, and employee and physician engagement also increased. All of the improved measures are sustained.


Healthcare reform in the United States struggles because the organization design challenges are great and the change difficulties even greater. Fairview’s experience provides important evidence and lessons that can help advance our understanding of effective healthcare and create more sustainable healthcare systems. This chapter provides healthcare system administrators evidence and alternatives in the pursuit of implementation.




The authors are grateful to Val Overton, Julia Harrington, and Sally Wahman for their contributions and insights into the change and design process. This case drew on information provided in interviews, the Fairview website, and published articles on the change process.


Winby, S., Worley, C.G. and Martinson, T.L. (2014), "The Design and Acceleration of Healthcare Reform/ACOs: The Fairview Medical Group Case", Reconfiguring the Ecosystem for Sustainable Healthcare (Organizing for Sustainable Effectiveness, Vol. 4), Emerald Group Publishing Limited, Leeds, pp. 31-68.



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