Title

Adopting The Integrated Provider-Payer Health Plan Model

Author

Jacob Mentele

Date of Award

5-31-2015

Document Type

Capstone Project

Disciplines

Healthcare Leadership

Degree Name

Master of Professional Studies

Department

Healthcare Leadership

Advisor

Irene Frederick

Keywords

Hospital Health Plan Provider Payer Model

Abstract

Hospital owned health plans are a reemerging trend that integrates both provider and payer in one organization. But vigorous debate exists among healthcare experts as to whether hospital owned health plan models are worthy of adoption. Healthcare organizations are increasingly consolidating provider and payer to increase competitiveness in the healthcare market and to meet the demands imposed by the new healthcare law. Thus, provider-payer consolidation is becoming increasingly popular. Research into health systems, such as Kaiser Permanente, Intermountain Healthcare, and the University of Pittsburgh Medical Center provide greater insight on this topic. This capstone investigates the pros and cons of hospital owned health plans and delivers valuable information to health systems wanting to embark on creating their own insurance plan.

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