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Hospital-Owned Health Plans: Can a Hospital Effectively Run Its Own Health Insurance Company?

There are 2 Excellent Papers by Milliman Authors Courtney White and David Hayes on What It Would Take for a Hospital to Run Its Own Health Insurance Plan. The First Paper Describes Specific Barriers the Hospital Would Need to Overcome: 1) The Appetite for Cost-Control Through Managed Care 2) Start-Up Costs, Initial Financial Losses The Second Paper Has an Excellent Diagram of How Much Lower the Hospital-Owned Health Plan's Premiums Could Be Based On: 1) Percent Steerage of Plan Members to Its Own Doctors and Hospitals (i.e. Stopping 'Leakage') 2) Percent Decrease in Unit Cost for Services Through Greater Efficiency If a Hospital-Owned Health Plan Were to Achieve Maximum Results with the Milliman Model, It Would Only Be Able to Offer Health Insurance Premiums That Were 8% Lower Than the Competition. That's Not That Much. However, the Milliman Model Does Not Appear to Take Into Account Decreased Hospital Utilization as a Result of Improved Primary Care--as Has Been Implemented by Intermountain Healthcare in Utah. Intermountain Lowered Hospitalizations by 20%... Could a Hospital-Run Health Plan Do the Same? Sources: https://us.milliman.com/-/media/milli... https://www.milliman.com/-/media/mill... AHealthcareZ is 200+ Healthcare Finance Educational Videos. 💥 BOOK: Check out Dr. Bricker’s Book 16 Lessons in the Business of Healing here: https://www.ahealthcarez.com/healthca... AHealthcareZ Viewers Include: Employee Benefits Professionals, HR, CFOs, Insurance Brokers, Benefits Consultants, Doctors and Nurses in Leadership Roles, Hospital and Health System Administrators, Health Insurance Carrier and PBM Professionals, Pharma and Med Device Professionals, Academic Professors and Students in Healthcare Administration and Public Health. 90,000+ Views Per Month Across All Platforms. Visit AHealthcareZ.com to Subscribe to the Healthcare Finance Video Newsletter.