"The difference with us is that we are limiting the network to our providers where we have some serious control over quality and coordination. We can make it a much simpler process to get into care and get coordinated care among the various providers," Gold says.
"We are also setting the price lower than almost any other plan out there in the commercial marketplace now or even projected to be on the exchange. We are going to be about 10% or more lower than the Oxford Liberty plan which is the lowest in the market. The numbers we have seen right now [show] we are about $420 for an individual on the exchange this October on the silver plan. That is what has been approved so it is public. We have also seen that Aetna is about $600 for the silver plan on Long Island. United's plan that is out there is going to be about 30% higher than us."
Gold says CareConnect gives North Shore-LIJ the opportunity "to improve our ability to coordinate the care not just for this product but for anyone who comes into our health system. We are using this as a way to transform the model of care from fee-for-service to one where there are alternative arrangements for reimbursements. It has a major effect on the way you deliver care for everyone."
Healthcare economist Adam Powell says CareConnect is part of a growing trend towards payer-provider integration.
"We have recently witnessed the acquisition of West Penn Allegheny Health System by Highmark and the acquisition of Neighborhood Health Plan by Partners HealthCare," he says.