North Shore-LIJ Health System to Launch a Health Plan

John Commins, for HealthLeaders Media , August 1, 2013

"As has long been demonstrated by Kaiser Permanente, when the delivery and financing of healthcare are integrated it is possible to offer high-value, innovative services that are otherwise less feasible. Integrated delivery systems are able to invest in services that improve quality and lower costs, but may not be billable using conventional fee-for-service means. As the insurer arm of an integrated delivery system can capture the savings from unbillable provider services the services can be financially justified."

Powell, president of Boston-based consultants Payer+Provider Inc., says that North Shore-LIJ can use CareConnect to increase the size of its patient population.

"Patients covered by the health plan are steered towards North Shore-LIJ providers," he says. "As the health system works toward treating more patients under value-based payment arrangements it has invested in developing the capabilities necessary to manage risk and keep patients out of the hospital. By running a health plan, North Shore-LIJ increases its ability to financially benefit from the risk management capabilities that it already must develop."

Alan Murray, vice president of managed care at North Shore-LIJ says CareConnect "signals a different way for health insurers and providers to work together."

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5 comments on "North Shore-LIJ Health System to Launch a Health Plan"

Seth chandler (12/17/2014 at 1:45 AM)
Let me save you some aggravation...don't ever ever ever sign up for this insurance. I had the misfortune of paying an inordinate amount of money for this insurance for a two month period. During this period, they denied paying for claims, charged hidden fees, and charged multiple copays for one doctors visit. Their customer service only offers to file a grievance with their grievance department, who won't speak to you and denies your grievance anyway. There is no other oversight in ensuring that their policies are adhered to. Please I urge anyone considering this insurance to think before signing up, as you will be paying far more than just your monthly premium.

Linda Salvio (9/25/2013 at 9:41 PM)
I reside in the NS LIJ area and I was interested in knowing how this coverage will be accepted state-wide if perhaps you are traveling or have a student residing in another state or abroad. Thank you

robert in smithtown (9/8/2013 at 6:24 AM)
Is there an rss feed or twiter hashtag or email list to get on for more info on this? Id like to know more specifics as they become available, which doctors will be available, etc.




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