Towards an integrated care organization at Hôpital du Jura bernois

The Bernese Jura Hospital is a pioneer in the Swiss healthcare system. The facility is becoming an integrated care organization and will offer an alternative basic insurance model with the objective of quality of care and lower costs.

Swiss Medical Network (SMN), the insurer Visana and the canton of Bern announced Friday in Moutier that they have joined forces to create a unique health system in Switzerland for the population of the Jura Arc. The concept of integrated care is to provide medical and insurance benefits in a coordinated way through a single entity.

The principle is to bring together in the same organization all the actors who have, in the current system, divergent interests, customers, insurers and healthcare providers. “It’s quite a historic moment with this paradigm shift in the Swiss healthcare system,” said SMN Chairman of the Board Raymond Loretan.

With the entry of the insurer Visana into the capital of the Hôpital du Jura bernois SA (HJB) held by SMN and the canton of Bern, the care network will be able to offer its own health plan, an alternative to the traditional system of Health Insurance. The Bernese Jura Hospital becomes the Réseau de l’Arc and will offer an alternative basic health insurance plan from 1 January 2024.

Qualitative approach

The care organization Réseau de l’Arc will manage the health capital of people who choose this health plan instead of their traditional basic health insurance. The patient who opts for this system will be offered a doctor who will be his interlocutor.

The provision of services and the insurance product are the responsibility of a single organization. The costs of medical services are entirely taken by the organization of integrated care and financed by a premium per head and per patient.

This model is inspired by Kaiser Permanente, an integrated care organization present in the United States. In order to motivate all players to act responsibly, the current fee-for-service system for service providers is replaced by funding per member.

This integrated care organization therefore favors a qualitative rather than a quantitative approach, explained Antoine Hubert, managing director of the board of directors of SMN. ‘There is a clear incentive to prevent rather than cure’. The other insurances will remain the alternative to this new product.

‘The health system needs an evolution’, underlined Bernese State Councilor Pierre Alain Schnegg, noting that the rise in premiums is a sign that something is wrong. “The current system has reached its limits, it is time to renovate it,” added the director of health.

New shareholder

To set up this first integrated care organization in Switzerland, Visana will take a stake in the share capital of the HJB, whose corporate name will become Réseau de l’Arc SA. The health and accident insurer will take a stake through a capital increase.

Visana will thus become the 3rd shareholder of the health organization alongside SMN and the canton of Bern. The private group of clinics and hospitals in Switzerland will lose its majority shareholder status. As of January 1, 2023, it will again become a minority shareholder in equal shares with Visana and the canton.

For Visana Chairman Lorenz Hess, a new era is dawning for the Swiss healthcare system. This model of integrated care. ‘We offer our customers in the Jura Arc innovative insurance solutions adapted to their needs’.

/ATS

.

Leave a Comment