Feb 22, 2016 | Laboratory Management and Operations, Laboratory News, Laboratory Operations, Laboratory Pathology, Uncategorized
Provider-health plan integration in Wisconsin may serve as model for hospitals and health systems nationwide as they establish their own health insurance plans
One interesting new trend in healthcare is the growth in the number of provider-owned health insurance plans. This is a development that could be auspicious for local clinical laboratories and anatomic pathology groups because most provider-owned health plans want local labs in their provider networks. This includes contracting with their own hospital labs.
In fact, experts at the Deloitte Center for Health Solutions believe that provider-sponsored health plans are “a potentially disruptive industry innovator.” If this assessment plays out, provider-owned health insurance plans may make big inroads on the market share currently held by insurance industry giants such as UnitedHealthcare, Anthem, Aetna and others. (more…)
Sep 28, 2015 | Coding, Billing, and Collections, Laboratory Instruments & Laboratory Equipment, Laboratory Management and Operations, Laboratory Pathology, Laboratory Testing
As national health insurers push more risk to hospital systems and medical groups, many hospital administrators become more interested in establishing their own health insurance companies
New modes of provider reimbursement—such as bundled payments and budgeted payments—are motivating hospitals and health systems to reconsider their existing relationships with health insurers. Hospital administrators want to control the dollars they save by improving patient care, instead of allowing insurance companies to capture that money.
To accomplish these goals, more and more hospitals and health systems across the country are making one of three moves:
• Funding their own health plans;
• Partnering with health insurance companies; or,
• Buying health insurance companies.
As this trend gathers momentum, it will put the medical laboratories of hospitals in a much better position to regain access to patients. It can be expected that hospital administrators will include their own clinical laboratories and anatomic pathology providers in their own health insurance provider networks. (more…)
