Classifying the Integration of Healthcare Providers and Insurers.

ABSTRACT: The value-based payment reform prompted by the Affordable Care Act has stimulated vertical integrations of healthcare providers and insurers. The consequences of these integrations may vary significantly depending on the markets and entities involved. This article points out the limitations of familiar binary classifications for provider-insurer integrations in prior studies. To address these limitations, we propose a framework and taxonomy that include four key aspects for examining variations in provider-insurer integrations. The first is from the care delivery perspective; it sheds light on levels of care services owned by an integrated system and their variation across regions within the system. The second is from the insurance markets' perspective; it pertains to insurance markets in

SUBMITTER: Liang X 

PROVIDER: S-EPMC12496020 | biostudies-literature | 2025 Nov

REPOSITORIES: biostudies-literature