Soraya	
  Ghebleh	
  
	
  
	
   Private	
  insurance	
  companies	
  know	
  and	
  understand	
  that	
  if	
  they	
  wa...
insurance	
  companies	
  to	
  be	
  addressing	
  these	
  issues?	
  The	
  amount	
  of	
  questions	
  could	
  
cont...
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Soraya Ghebleh - Thoughts on Private Insurance

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These are some thoughts of Soraya Ghebleh on private health insurance's need to innovate.

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Soraya Ghebleh - Thoughts on Private Insurance

  1. 1. Soraya  Ghebleh       Private  insurance  companies  know  and  understand  that  if  they  want  to   remain  important  stakeholders  they  need  to  play  the  game.  They  can  no  longer   continue  to  bring  in  high  profits  without  addressing  the  triple  aim  and  the  best  way   for  insurance  companies  to  stay  engaged  is  to  begin  to  innovate.  Insurance   companies  know  that  they  need  a  competitive  edge  before  the  healthcare  system  is   completely  turned  over  to  government  control  and  they  no  longer  have  a  claim.   There  are  still  extreme  amounts  of  money  to  be  made  from  healthcare  even  with  the   goals  of  reducing  waste  and  improving  quality.  Private  insurance  needs  to  innovate   now  and  ingrain  themselves  in  the  system  while  healthcare  changes  to  ensure  that   they  are  not  cut  out.  It  is  naïve  to  believe  that  insurance  companies  are  rushing  to   come  up  with  solutions  to  healthcare’s  bigger  problems  out  of  altruism  and  interest   in  doing  the  right  thing.  The  likely  explanation  is  that  the  more  innovative  they  are   and  the  more  carefully  they  design  new  plans  that  are  attractive  to  buyers,   employers,  providers,  and  government  officials,  the  more  marketable  the  company   will  be.  Translating  the  data  and  the  research  and  the  pilot  programs  that  have  been   tested  will  also  prove  to  be  more  difficult  in  practice.  Will  the  current  Medicare   population  really  utilize  mobile  applications  on  their  phone?  How  will  medical   device  companies  react  to  disruptive  innovation?  How  will  pharmaceutical   companies  handle  a  push  to  switch  to  generic?  Will  specialty  surgeons  stop   performing  volume-­‐based  surgeries  when  they  have  overhead  and  bottom  lines  to   meet  in  order  to  stay  afloat?  Where  will  both  rural  physicians  and  solo  practitioners   fall  under  the  new  ACO  and  wannabe  ACO  models?  Is  it  really  the  role  of  private  
  2. 2. insurance  companies  to  be  addressing  these  issues?  The  amount  of  questions  could   continue  on  and  on  but  until  we  really  look  at  the  reality  of  what  drives  provider   behavior  and  take  into  account  how  these  overhauling  transitions  will  affect  them,   we  may  be  left  with  another  managed  care  fiasco  that  leaves  both  providers  and   patients  unhappy  and  in  no  better  place  than  before.    

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