By Harvey Billig
With the pending expansion of healthcare insurance to millions of newly insured, it is time to re-examine the delivery system if one wants true reform that is financially sustainable. This requires an analysis of how to integrate doctors, hospitals, other providers, insurance companies and pharmaceutical suppliers in a workable and affordable delivery model that can be adopted relatively rapidly in most areas of the country.
This can be done without creating new Kaiser Permanentes or large healthcare cooperatives by means of loose coalitions of providers contracting with a cost-efficient third-party administrator backed by a not-for-profit or for-profit insurance company. The insurance company provides oversight and the necessary reinsurance while physicians are the primary agents of utilization review.
This model is called the community-based delivery system.