The Role of Health Plans, Employers, and Patients in Health Care Delivery

Abstract

While the core of value creation in health care delivery takes place at the provider level, other stakeholders have crucial roles to play as well. Health plans, employers, and patients can all make a significant contribution to improving value. However, this opportunity is largely lost in Germany. Health plans have focused on insurance instead of helping subscribers navigate through the health care system or working with providers to improve the value of care. Employers have taken a passive role, despite paying for a major share of health care costs through employer contributions to health insurance and by covering the first six weeks of sick leave. Patients themselves have often not lived up to their responsibilities to improve their health and their care, and they have failed to demand that health care delivery be more patient-centered, focused, and outcome-oriented.