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加州蓝盾公司案例研究
请仔细阅读该案例，并对以下问题做出简要回答。你对这些问题的回答是为了准备10月5日的课堂讨论。答复可以很简短，并采用任何有助于你参与讨论的格式（子弹头、段落等）。
1.健康保险公司盈利能力的主要驱动因素是什么？你如何看待行业盈利能力在未来5-10年的变化？
2.你是否同意Paul Markovich的观点，即非营利性保险公司最能推动医疗保健行业的变革？为什么或为什么不同意？
3.考虑综合供应商/保险系统，如凯撒，传统的 “断开 “系统，其中保险和护理由不同的实体提供，以及ACOs，如蓝盾与Dignity Health和Hill Physicians Group在萨克拉门托建立的一个。从病人、医生、技术创新者（即药物公司、诊断公司）和整个医疗系统的角度来看，你认为每个系统的优点和缺点是什么？
4.你会建议蓝盾公司在个人交换市场采取什么策略？您是否建议蓝盾公司提供交换产品，如果是的话，他们在定价上应该有多大的积极性？您认为个人决定选择哪种保险计划的驱动力是什么？
5.健康保险行业整合的驱动力是什么？您是否建议蓝盾公司寻找更多的收购项目？如果是这样，他们应该瞄准哪类公司，为什么？蓝盾公司是否应该对被收购持开放态度？为什么或为什么不？
Blue Shield of California Case Study
Please read the case carefully and write brief responses to the questions below. Your responses to the questions are intended to prepare you for in-class discussion on October 5. They can be brief and in any format that will support your participation in discussion (bullets, paragraphs, etc.).
- What are the main drivers of profitability for a health insurer? How do you see industry profitability changing over the next 5-10 years?
- Do you agree with Paul Markovich’s view that non-profit insurers are best positioned to drive change in the health care industry? Why or why not?
- Consider integrated provider/insurance systems such as Kaiser, traditional “disconnected” systems in which insurance and care are provided by different entities, and ACOs such as the one built by Blue Shield in combination with Dignity Health and Hill Physicians Group in Sacramento. What do you consider the advantages and disadvantages of each system from the perspective of patients, physicians, technology innovators (i.e., drug companies, diagnostics companies), and the overall health care system?
- What strategy would you recommend Blue Shield pursue for the individual exchange market? Would you recommend Blue Shield offer an exchange product and, if so, how aggressive should they be on pricing? What do you believe will be drivers for individual decisions on which insurance plan to choose?
- What are the drivers of industry consolidation in the health insurance industry? Would you recommend that Blue Shield look for additional acquisitions? If so, what type of companies should they target and why? Should Blue Shield be open to being acquired? Why or why not?
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