Early in my career, I served as a mid-level executive with an inner-city hospital in Philadelphia that was heavily reliant on capitated payments from Medicaid and commercial managed care plans. We didn’t think of it, but in those days, we were pioneers. My CEO struggled with, then made the transition from, worrying about hospital census to keeping “plan members” out of the hospital and medical loss ratios. We were early adopters of “population-based health” and were living in, out of necessity, an insurance model.

It is interesting how this experience has prepared me for our current health care environment. Recently, I had the opportunity to attend a program from the American College of Health Care Executives titled “Care Continuum from ER to Post Acute: Making the Argument for Partnerships.” The focus was on keeping patients out of the hospital...

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