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？
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?