Health care experts are considering whether Kaiser Permanente's integrated care system could be a model for other health systems as they continue to adapt to changes brought by the Affordable Care Act (ACA), Jayne O'Donnell writes in USA Today.
According to O'Donnell, Kaiser fully integrates the hospital, doctor, and insurance aspects of health care, like an ACO "on steroids." As a closed network that acts as its own insurer and medical group, Kaiser focuses on affordability, technology, electronic health records (EHRs), and care. Experts say providers could adopt that strategy to obtain financial bonuses for more efficient and effective care under the ACA.
As an insurer, Kaiser benefits from reducing patients' length of hospital stay, unlike hospitals that lose money when they discharge patients. Kaiser CEO Bernard Tyson, who believes the company's methods should "be considered by the industry," says more traditional hospitals' "incentives are not aligned with efficiencies." Therefore, by joining forces and adopting similar models, other hospitals could save money and increase efficiency, according to USA Today.
While some observers remain skeptical of Kaiser's system and ACOs, Paul Ginsburg, founder of the Center for Studying Health System Change, says the idea is gaining traction as more people "talk with great respect about Kaiser in California" (O'Donnell, USA Today, 8/7).
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The 4-step math exercise for population health
For health systems to become population health managers and remain financially viable, the leadership team will have to attain a comprehensive economic perspective.
Such perspective requires integration of payer, physician, health system, and patient considerations to understand the financial net impact on the health system as a whole.
Moreover, that economic understanding means health systems can pace all population health management initiatives according to targeted financial net impact including expected return on investment.