In the not so distant past there was an health care industry trend toward the merger of the insurance and health care delivery systems which lowered costs at the expense of consumer choice. Consumers ultimately balked at the choice limitation and the trend dissipated back toward the customary separation of insurance and delivery along the fee for service model. With the rise of Accountable Care Organizations under the Patient Protection and Accountable Care Act, the past is back as the future. Recently Steward Health Care System, LLC (successor to the six hospital system, Caritas Christi, in Massachusetts) announced that it will provide an new insurance plan built around the restriction that all consumer routine health care needs with be provided by Steward physicians. Cerebus Capital Management LP owns Steward.
Pricing for the plan is designed to appeal to small businesses and individual consumers who will find the price points at 15% to 30% below the market attractive enough to overcome the concern about choice of care providers. Steward plans to work with the Tufts Health Plan to develop the new plan to be called Steward Community Choice. The Steward system, is an integrated system that plans to control prices and improve care through the use of its electronic medical records to achieve an efficient continuum of care and provider accountability through the use of evidence based protocols for treatment. What is different from the past is the ability of plan management to fix provider efficiency and accountability through the use of electronic medical records and the incentives now and in the future available under the PPACA. Choice will come at a cost that many employers, particularly small employers will be increasingly unwilling to pay.