Pittsburgh-based UPMC, Danville, Pa.-based Geisinger Health System, Salt Lake City-based Intermountain Healthcare, San Diego-based Sharp HealthCare and Scripps Health, along with many others, have their own health insurance arms. The risk-intensive environment isn’t for every system, but as healthcare reform increasingly emphasizes population health management, the allure of becoming both payer and provider grows.
Frank Williams, CEO of Evolent Health in Arlington, Va., says this integrated approach is spurring hospitals to explore the option. “There’s an opportunity to change from a ‘come-into-the-hospital-or-doctor’s-office’ model to a much more coordinated proactive care management model,” he says. “Shifting focus to preventive care can dramatically lower costs, but you can’t do that if you don’t change the way you’re getting reimbursed.”
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