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Should health care systems become insurers?

Dave Chokshi November 5, 2013

Shah, NR, Chokshi, DA. JAMA 2013; 310(15):1561–1562.

Incentives under the Affordable Care Act (ACA) are spurring increasing numbers of health care systems to assume the risk of paying for patient care, blurring the boundaries between care delivery organizations and insurers. New arrangements such as bundled payments, value-based purchasing, and accountable care organizations (ACOs) transfer financial risk from payers to health care systems. The union of payer and care delivery functions may engender opportunities for health systems to invest in prevention and more comprehensive, coordinated, patient-centered care.

The full text of this article is available from JAMA.

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Dave Chokshi, MD, MSc is a primary care physician with interests in public health and innovation in health care delivery. As an Innovation Fellow, he is an active consultant to VACI on its portfolio of projects and the implications of the Affordable Care Act for VA. He most recently served as a White House Fellow with VA Secretary Eric Shinseki.

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