For UW Health, Health Plan Ownership Provides Financial Stability

Abstract

For health systems seeking a path forward and upward in a value-based environment, ownership of a health plan can yield many positives, including a chance to drive value-based care, financial margin improvement, and opportunities for rewarding partnerships. However, being both a payer and a provider—a “payvider”—can make extraordinary demands on both the health system and health plan. Developing this hybrid business has been a learning experience for UW Health, an academic medical center that, like others in academic healthcare, was built on a fee-for-service model. Today, UW Health is a majority owner of what has become the state's largest provider-owned health plan. As illustrated here, health plan ownership is not for every system. The burdens are heavy. But for UW Health, it is an important component of both mission and margin.