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A case for conceptual competency in an integrated delivery system.

Integrated delivery systems come in more than one shape--vertical, horizontal, or a combination of both. Leadership competencies vary according to the type of system. The most complicated is the combination; this and horizontal requires that the leader has the competency in the conceptual area. The business and health care model are highly congruent, with useful applications from industry. The skill and aptitudes required for conceptual competency are discussed in relation to a combined vertical and horizontal system complicated by academia and city politics.