I receive several healthcare industry newsletters each week. Most of them seem to assume that health insurance companies, as they exist today, are on their way out as the healthcare industry restructures. At the very least, these publications believe that our current ‘fee for service’ model is a dinosaur that will be extinct in the next ten years.
Some people think ACO’s (Affordable Care Organizations) will take the place of the health insurance industry. These are provider groups (including hospitals) who bear the risk for providing all care for a patient for a certain amount of money that is now paid by an insurance company or Medicare. They are expected to use lots of preventive care and to benefit from the large amount of data their electronic health records (EHRs) will gather to provide evidence-based care in a profitable way. Kaiser Permanente is the example of this kind of organization that many people refer to.
The logical extension of these arrangements is that the ACO would contract directly with an employer or group of employers on behalf of their employees cutting out the insurance company. This would be a kind of pre-paid health care where the ACO is on the line for providing best care and keeping members healthy.
Oh, wait….isn’t that what HMO’s were? You remember….Health Maintenance Organizations. In fact, I think Kaiser was long considered an HMO. It has certainly been a most successful one!
For myself, I am a fan of a single payer system…..like Medicare but for everyone…..with premiums paid by employers or from income taxes or in a variety of ways so everyone can be covered.
What models of funding healthcare do you see as possible and even likely? Do you think insurance companies are with us for the long-term? Where do you think behavioral health will fit in this ever-changing, rapidly evolving arena?
Please share your thoughts and comments below.