As Insurers Balk on Risk Sharing, Providers Take Charge
Many hospitals and health systems aren't waiting for insurers to implement risk sharing into their contracts. Instead, providers are experimenting on their own—especially those that already own health plans.
As the third annual HealthLeaders Media CFO Exchange in Colorado Springs winds down to a close, I am struck by the wide variety of experience around the country surrounding population health initiatives and risk sharing for hospitals and health systems.
Before I go on, there's nearly universal agreement that healthcare takes up too much of the nation's GDP, and that outside of rationing care, which is unlikely to happen even in the long-term, risk sharing is likely the best way to reduce cost growth.
By risk sharing, I mean that at least part of hospital and physician payment is "at risk" based on how well providers meet certain targets on processes, overutilization, readmissions and other metrics.
In some geographical areas, health plans are being innovative. But in most areas, they don't seem to be, not on a broad scale, that is. Instead, with the consent of employers, payers are content to offload risk onto patients through high deductible health plans.
- How Top-Ranked MA Plans Earn Their Stars
- Readmissions: No Quick Fix to Costly Hospital Challenge
- How Hospitals Can Become 'Upstreamists'
- 4 Ways to Lower the Cost to Collect from Self-Pay Patients
- House Calls Key to Pioneer ACO Success
- How Telehealth Pays Off for Providers, Patients
- 4 Tips for Managing Employed Physicians
- WellPoint Dominates Nearly Half of Markets, AMA Says
- Defensive Medicine Still Prevalent Despite Tort Reform
- CMS Offers Some ACOs $114M for 'Upfront' Costs