ACOs Make Healthcare Providers More Like Health Insurers

I’m not sure why I haven’t seen more people talking about this idea. When you start to look at the ACO financial models, I think there are some real comparisons between what health insurance companies do with patient populations and what ACOs will have to do with patient populations.

Should ACOs be looking to insurance companies on how to manage patient populations?

Another interesting dynamic at play here is that many insurance companies are acquiring provider organizations. Is this because insurance companies want to leverage their expertise with patient populations to get at the ACO money that is getting ready to flow?

I admit that I’m not an expert on all the various methods of insurance companies. Maybe they were under a very different model than ACOs, but even then it seems like the principles could still apply. Even just starting with the way insurance companies use data to analyze patient populations. Shouldn’t that same data analysis be able to be applied to an ACO?

I’m sure just thinking about the idea makes most doctors wonder if they want to keep practicing medicine. No doctor I know wants to be in the insurance business. They want to care for patients. Anything that takes them away from that is a distraction.

What are your thoughts? Can an ACO learn from insurance companies?

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

3 Comments

  • Wow, insurance companies had the opportunity to learn about patient population management during the 1980- early 1990’s with the growth of effective HMO’s. Instead they converted those they bought/controlled into tight U/R bottom-line focused systems. Look to physician led health systems like Kaiser for true population management models. Being at financial risk is a key factor…all insurance can do is tighten approvals. It is the the physician that impacts the individual treatment, or physician (provider) led system that is capable of redesigning delivery. I do not want the insurer to continue to dictate the practice of medicine to our licences providers, who do you trust?

    It is all about values, and I am betting on the healthcare system to repair itself.

  • Peter beat me to the punch. When I was a member of HIP (of New York) 30 or so years ago, they really tried to look out for the health of the patient while still controlling expenses. The idea was great, but the paper records and scheduling made a real mess of things. So now we have a new opportunity to try again.

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