ACOs will replace insurers, former Obama adviser says


Health insurers as we know them will likely cease to exist as accountable care organizations replace them, according to Ezekiel Emanuel, former White House healthcare adviser.

"I do believe that the health insurance companies that we all love to hate are going away," he said this week during a speech at Princeton (N.J.) University, reported the Daily Princetonian. "I think this is the wave of the future."

Ezekiel, now a department chair at the University of Pennsylvania, expects insurers to be obsolete by 2025. By then, ACOs will have assumed both clinical and financial risks for their members, thereby eliminating the need for insurers, which exclude some consumers and impose administrative barriers, he said.

If they want to remain competitive, insurers must move into risk management or merge with providers to create integrated delivery systems like Kaiser Permanente. Insurers could benefit from following Kaiser Permanente's integrated healthcare model that focuses on prevention, wellness and electronic health records. The model has allowed the company to provide care that's up to 20 percent below market average costs, FierceHealthPayer previously reported.

However, Ezekiel said ACOs have room for improvement. They must compete to provide care at lower prices while referring patients to high-quality facilities for chronic conditions, like cancer, the Daily Princetonian reported.

ACOs "have to figure out how to deliver more efficient aid in a coordinated way," he said. "The one thing they lack to be listed on the [health insurance exchange market] is the financial risk management of insurance companies. But that can be bought."

Ezekiel noted that he doesn't foresee a single-payer system as the future of the U.S. healthcare industry. "I just don't see healthcare for all," he said, adding that it's "just not an American value."

To learn more:
- read the Daily Princetonian article

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