"The successfully established
[provider-led health] plans came of age in a different era, at a time when
employers and in some cases state governments were looking for alternatives to
the dominant Blue Cross Blue Shield plans." By contrast, "the problem
with a lot of recently formed provider-sponsored organizations...was they
thought they could help deliver more efficient, high quality care — but they
entered the business without having the capabilities of delivering on what you
really need to be as a provider-sponsored plan" — i.e., being able to
provide top-notch care more efficiently under an integrated health system.
— Allan Baumgarten, a
Minneapolis-based independent analyst of health markets, tells Health Plan Weekly
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