By Brian Celiberti
For several years, hospitals have been merging in an attempt to streamline their operations and increase their buying power through volume. Today there are very few stand-alone hospitals. Most are part of a bigger hospital group, or health system. Sometimes called an integrated delivery system, a health system is group of affiliated doctors, hospitals, and facilities, organized together under one parent company.
Health systems have also been buying up physician groups and doctor practices, who agree to join the health system to escape the burdens of increased regulations and administrative costs.
A new type of health plan designed around integrated health systems is an inventive way to take advantage of the health system model to reduced costs and improve patient outcomes. This approach was very successful in the Midwest, and we are replicating the model in the New York tri-state area.
Here’s how it works: Employees in employer-sponsored plans choose between multiple health systems available to them during open enrollment. Families opt-in to the system that best meets their preferences on criteria such cost, quality, location, availability of doctors, and more. They then receive all of their medical care from their chosen health system for the plan year. Health systems are incentivized to lower their prices to attract members and their families’ health care dollars, and to improve health care quality so the members will come back the next year at open enrollment.
Another benefit of integrated health system for patients is that all doctors have access to the same electronic medical records that give them a holistic view of the patient, and there’s less paperwork to fill out.
By building health plans around integrated health systems:
- Employees pay less out of their paycheck for their medical benefits
- Employers offer more choice and better plans at lower cost
- Doctors are better able to coordinate care
- Families and doctors build a more clinically rewarding relationship
- Health systems that perform keep members and their families in their delivery system
Create® is such a health plan, and it improves members’ health outcomes while lowering employer and member health care costs.