Provider-Sponsored Health Plans: Are They Right for You?

摘要

As we struggle in the United States with healthcare costs that are two to three times greater per person than those in other Organisation for Economic Co-operation and Development countries, employers, individuals, and the federal government are forcing providers to deliver higher-quality care at a lower cost while improving the health of populations (i.e., the Institute for Healthcare Improvement's Triple Aim). Much hope is being placed on alternative payment models and the creation of accountable care organizations (ACOs), a newer version of the integrated delivery network. What is the role of the provider-sponsored health plan in the evolution of healthcare? Past precedent suggests that if the hospital provider's health plan is treated as a competitor and is not truly integrated into the health system, it will be destined for acquisition when the parent company or hospital provider needs capital.