North Shore-LIJ Health System to Launch a Health Plan
"I also think it signals a different way to design products and for doctors, hospitals and insurers to design their plans so that services are coordinated better and that the highest quality providers rise to the top," he says.
"Those providers who are not involved in these kinds of activities or those insurers who are not involved with providers who are willing to be in these kinds of activities will fall by the wayside. Plans that do this, whether it is a provider that owns the plan or a plan that wants to work with providers like us, are the ones that are going to succeed and be very successful under the Affordable Care Act."
Gold says he does not anticipate that CareConnect will create friction with established health plans that now do business with North Shore-LIJ.
"We will work and need to work with every payer and every carrier," he says. "I am anticipating that this will improve it because it gives us the capability to work with them in a way we haven't had before. If I can manage the care of my own employees and the members who join our plan, we can help manage their care better too. And if we can manage their care better too, they have the opportunity to share risk and premium and coordination and to sell products with us. We have done that in a number of cases already with the full knowledge of the plans that we are going to go out into this market. We didn't hide from anyone that we're trying to do this."
John Commins is a senior editor with HealthLeaders Media.
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