HealthPartners-Park Nicollet merger greeted with caution [Pioneer Press, St. Paul, Minn.]
By Christopher Snowbeck, Pioneer Press, St. Paul, Minn. | |
McClatchy-Tribune Information Services |
It's a question that doctors, nurses, insurance agents and health care consultants debated
The deal, which needs federal approval, would create an insurance and health care entity so large for this region that some independent doctors fear it might have an unfair advantage. Nurses and insurance agents also voiced concerns Friday.
The newly merged organization, to be called
But some experts said the affiliation between
"In terms of efficiency, this may be the best model," said
"The danger is, if you aren't assertive in maintaining that cost focus, you could become
even more expensive," Parente added.
Before the merger announcement Thursday,
The newly merged organization will include another
Dr.
For the most part, the care network at
But there are areas of overlap. Both systems in 2011 opened clinics in
"The strategic focus is on using quality and great expertise to actually lower the cost of care," Abelson said. "There are huge opportunities to use quality to make care more affordable."
Although hospitals traditionally have been the most visible pieces in health care systems, clinics and outpatient centers have become increasingly important.
It's those clinics, plus the physicians who provide care in them, that illustrate why the merger between
"Today's environment is all about population health and total cost of care -- how a system can provide all the care that's needed for a population of people," he said. "If you're going to deliver care to a population of people, you need a full range of physician services and collaboration among those physicians."
For its first year of operation, a new 21-member board of directors will lead the organization, Abelson said, with membership comprised of 12 directors from
Abelson said the merger agreement includes a "super majority clause" that must be satisfied when the board is voting on significant decisions -- a rule that "gives us an equal voice," he said.
If the merger agreement gives
The federal overhaul of the nation's health care system in 2010 included a new program for paying doctors and hospitals that are linked with health insurance companies through affordable care organizations, often called "ACOs." The impetus of the law and other market dynamics have pushed more insurance companies and health care providers to merge in recent years, Parente said, although it primarily has been insurers that have driven the trend.
Halleland said the deal between
"In an ACO environment, the providers need to be able to manage or accomplish some of the actuarial functions, some of the care management tools and resources that traditionally have been in health plans," Anderson said. "The easiest way to do that is find a health plan that has that capacity and merge with them, but another way is to develop that capacity on your own."
What's implicit in Anderson's comment -- that the creation of big ACOs is inevitable -- is what makes some doctors, nurses and insurance agents nervous about the
"There is a concern that with these organizations getting really large, that they become so dominant that smaller players are kind of pushed to the side and have a much more difficult time operating and flourishing," said Dr.
Part of the idea with federal health care overhaul is that health care providers and insurers will share in the financial risks and rewards that come with responsibility for managing care for a group of patients within a budget. It's an idea that makes Swenson nervous.
"There's this big snowball rolling down the hill with this trend of saying: You delivery people, you take on the insurance risk," he said. "The bigger you are, the easier you can take on that insurance risk."
More than a decade ago, then-
Bringing those two things together remains "a bad idea," he said. Schneeman said he isn't critical of the
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