The large market share of Kaiser Permanente – an integrated managed health care service plan that bears medical risk like an insurer but also directly provides care though its clinics and hospitals – makes California a unique environment favorable to the formation of Accountable Care Organizations (ACOs). Kaiser Permanente accounted for 40 percent of individual and group plan enrollment in 2011, according to the California HealthCare Foundation (CHCF).
The dominance of the Kaiser model is a major influence on California’s health plans and providers to emulate that model to hold down costs and compete against it. The Golden State is also home to large physician organizations experienced in managing financial risk for patient care, easing the way for ACO growth.
A paper explaining California’s unique ACO market dynamics prepared by the Center for Studying Health System Change was posted this week at the CHCF’s California Health Care Almanac.
Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email