Hospital Organisation Seeks Risk. Insurers Say No Thanks.
Thursday, November 19, 2020
Well, here's a twist inwards the commons story, from Modern Healthcare:
Since 2002, Dan Wolterman has served equally president too CEO of Houston-based Memorial Hermann Healthcare System, Texas' largest not-for-profit wellness system, which provides assist inwards southeast Texas through xvi hospitals too has $4.2 billion inwards internet operating revenue.
MH: Do yous facial expression to come across Memorial Hermann accept on additional fiscal opportunity nether contracts?
Wolterman: We would honey to accept risk. The occupation is this: Very efficient providers similar Memorial Hermann amongst their doctors stimulate got been able to cut back inpatient admissions, hospital-acquired weather too infections, too ancillary testing similar MRIs too CT scans. With our full toll of assist too hence low, nosotros would honey to become too accept a opportunity contract. We would live on much amend off. We saved $58 1 thou m inwards the Medicare ACO. We received 50% of that from Medicare to divvy upwardly betwixt the physicians inwards our system. If they were all nether a opportunity contract, nosotros would stimulate got received all $58 1 thou m of that. But carriers exactly produce non wishing to part it amongst us. They say, “We honey how yous all are providing care, the character is outstanding too the toll controls are wonderful. You exactly perish on doing what you're doing. You're making us lots of money. We'll remain nether fee-for-service.”
So nosotros felt that nosotros needed to live on to a greater extent than aggressive. A span of years ago, nosotros decided to starting fourth dimension our ain insurance company. It is a fledgling companionship today, but nosotros are off the terra firma too nosotros are directly inwards the commercial too Medicare Advantage programs, too promise that volition starting fourth dimension the ball moving to where nosotros tin accept risk.
Since 2002, Dan Wolterman has served equally president too CEO of Houston-based Memorial Hermann Healthcare System, Texas' largest not-for-profit wellness system, which provides assist inwards southeast Texas through xvi hospitals too has $4.2 billion inwards internet operating revenue.
MH: Do yous facial expression to come across Memorial Hermann accept on additional fiscal opportunity nether contracts?
Wolterman: We would honey to accept risk. The occupation is this: Very efficient providers similar Memorial Hermann amongst their doctors stimulate got been able to cut back inpatient admissions, hospital-acquired weather too infections, too ancillary testing similar MRIs too CT scans. With our full toll of assist too hence low, nosotros would honey to become too accept a opportunity contract. We would live on much amend off. We saved $58 1 thou m inwards the Medicare ACO. We received 50% of that from Medicare to divvy upwardly betwixt the physicians inwards our system. If they were all nether a opportunity contract, nosotros would stimulate got received all $58 1 thou m of that. But carriers exactly produce non wishing to part it amongst us. They say, “We honey how yous all are providing care, the character is outstanding too the toll controls are wonderful. You exactly perish on doing what you're doing. You're making us lots of money. We'll remain nether fee-for-service.”
So nosotros felt that nosotros needed to live on to a greater extent than aggressive. A span of years ago, nosotros decided to starting fourth dimension our ain insurance company. It is a fledgling companionship today, but nosotros are off the terra firma too nosotros are directly inwards the commercial too Medicare Advantage programs, too promise that volition starting fourth dimension the ball moving to where nosotros tin accept risk.