"The skills necessary to be successful in the healthcare world are no longer just putting beds into hospitals and opening your doors," says Howard Gold, executive vice president and chief managed care and business development officer for Great Neck, N.Y.-based North Shore-LIJ Health System.
"There's not a day that goes by that someone doesn't call and say, 'We want to explore a relationship with you,'" says Mr. Gold
from North Shore-LIJ
These potential relationships come in all shapes and sizes, from joint ventures to affiliations, sponsorships to management agreements.
But to really hold North Shore-LIJ's attention, the partner and proposed model has to fit the system's vision of providing high-quality care that's highly accessible to patients.
"We don't just do things based on what's opportunistic," says Mr. Gold
"We were getting downward pressure on revenue from payers when, at the same time, we saw we could manage our own employees in a reasonable way," says Mr. Gold
"We said, 'Why don't we take this plan and sell it in the general marketplace?'"
applied for its insurance license from New York regulatory officials and received the green light about five months later, in August.
, the first provider-owned commercial health plan in New York, went on the state's health insurance exchange Oct. 1 for small groups and individuals.
The system hopes to enroll up to 15,000 people in the plan's first year of operation.
"There's a lot of buzz out there that North Shore-LIJ
is a name brand, and we think that we may get a good deal of business," says Mr. Gold
says developing the health plan is "very, very hard to do" and it has already forced North Shore-LIJ
to change the way it delivers care, as it makes administrators more cognizant of which sites of service, physicians and programs are most effective.
It's also changing the way the 15-hospital system interacts with other commercial insurers - but not necessarily for the worst.
"This does not mean, in any stretch of the imagination, that we'll only do business with our own insurance company," says Mr. Gold
To Mr. Gold
, diversifying is necessary for healthcare organizations to succeed.
Every other successful business has found a way to diversify the methods and mechanisms it has to deliver its products or services, he
, this not only includes its health plan, but also expanding into CVS Caremark's MinuteClinics and other retail settings, opening more urgent care sites, developing a medical complex without beds in New York's Greenwich Village and partnering with the once-troubled Lenox Hill Hospital in Manhattan in 2010.
"I don't buy the idea that we're diluting ourselves," says Mr. Gold