According to recent research, the total care health plans that are sponsored by providers are not functioning in an appropriate manner in insurance markets. This mainly stems from the fact that the plan providers are struggling to ensure that their total care plans adhere to the policies, procedures, and guidelines as set forth by the Affordable Care Act that currently exists within the United States. This research was brought to light by the blog Health Affairs. According to the information contained on this blog, those healthcare networks that are led by providers are not designed to function in the same manner as insurance companies.
The main reason that total care, provider-led healthcare plans are failing under the Affordable Care Act is that they lack the general level of expertise that is required to assess the various health risks that the current population faces. Additionally, they are unable to properly assess all of the costs that will be required to address those health risks. As a result of this, the healthcare plans are unable to appropriately price the products that they offer to consumers in the nation. This means that all of the efforts put forth into consolidating the total care healthcare providers in an effort to transition them into healthcare insurers are setting up those plan providers for complete failure.
This is becoming increasingly more evident among major health insurance providers. One example is UnitedHealth Group. According to several reports, this is the largest total care health insurance company within the United States. In attempting to correspond with the criterion as set forth by the Affordable Care Act, this company is having a difficult time in terms of compliance. Not only has this major provider informed the public that it has lost a tremendous amount of money, but, it has also informed the public that it may actually pull out of the current exchanges that it is involved in sometime in the year of 2017. This could prove to be totally disastrous for those that are bound by the current Affordable Care Act.
According to a doctor by the name of Joel Zinberg, the Affordable Care Act is actually pushing all of the nation’s current healthcare providers to a point where they have to mix into larger total care health systems. In doing this, it results in a higher level of risk for those providers. Additionally, many hospitals are now placing an emphasis on offering consumers total care health plans. While this is considered to be an ideal short-term solution for many patients, it could result in long-term detriment. When these systems, eventually, collapse based on the current expectations of the Affordable Care Act, there will likely be no bailout plan in place. To further these complications, it is quite likely that consumers will find themselves without total care health care coverage. Naturally, this will result in more fees and more problems in obtaining necessary health services.
