About Cooperatives
Agriculture
Childcare & Preschools
Co-op Professional Organizations
Economic Development
Energy
Finance & Insurance
Food
Funeral & Memorial Societies
Healthcare
Housing
International
International Development
Purchasing & Shared Services
University Co-op Centers
Worker-Owned
NCBA Home

Healthcare Cooperatives

Over the last twenty years, healthcare related cooperatives have emerged as a key strategy for

  • keeping healthcare costs and insurance premiums affordable for consumers and small businesses;
  • controlling the high cost of prescription drugs;
  • helping community-owned, non-profit hospitals remain independent;
  • improving the quality of home-based healthcare and assisted living;
  • helping small independent pharmacists compete with big box stores, allowing them to offer locally available prescription drugs.

Just about every type of cooperative—consumer, worker, and purchasing/shared services—can be found in the health care sector.

Consumer Cooperatives

Purchasing Cooperatives

Worker-owned Cooperatives

Consumer Cooperatives

Many Health Maintenance Organizations (HMOs) were originally consumer-owned cooperatives. Though competition and the high cost of healthcare have reduced the number of consumer-owned HMO co-ops, several still exist and offer competitive and quality services to their members.

Examples:

  • HealthPartners, Inc., based in Minneapolis, Minn., is the nation's largest consumer-owned HMO. The co-op and its related organizations provide health care services, insurance and HMO coverage to nearly 660,000 members.
  • Group Health Cooperative, based in Seattle, Wash., is the nation's second largest consumer-governed, nonprofit health care system. It provides coverage and care for one in 10 Washingtonians, with nearly 600,000 members.

Purchasing Cooperatives

Purchasing and shared services co-ops are growing in importance in healthcare. Purchasing co-ops now provide services to hospitals, independent pharmacies, and state governments.

    Hospital Group Purchasing Cooperatives

    Community-owned non-profit hospitals, university hospitals and others rely on national purchasing and shared services cooperatives that provide group purchasing for medical devices, equipment and other supplies, and provide training and other educational services for their members. The co-ops are owned and governed by the hospital members, and, in today's rapidly consolidating healthcare market, help them offer quality healthcare services at affordable prices, while remaining competitive with investor-owned hospitals. Without purchasing cooperatives, many small, community-owned non-profit hospitals would be even more subject to buyouts by investor-owned hospital networks.

    Examples include:

  • VHA Inc. is a nationwide cooperative owned and governed by community-owned health care systems and their physicians. VHA has more than 2,200 members—some of the nation's leading health care institutions. It not only negotiates contracts with sellers of supplies for hospitals, leveraging its group buying power, it also provides services relating to clinical training, healthcare worker safety, operational efficiency, management and other healthcare related services.
  • University HealthSystem Consortium is a purchasing co-op for University-based hospitals. Like VHA, it offers group purchasing and services to enhance the quality of services provided by its members.
  • Independent Pharmacy Purchasing Cooperatives

    With the advent of big box stores offering pharmaceuticals at reduced prices, many small, independently owned pharmacies have lost customers to nearby, or not so nearby multinational competitors.

    To help local pharmacies compete with conglomerates and continue offering affordable, locally available pharmaceutical services, pharmacy purchasing cooperatives allow small, independent pharmacies to band together to leverage the buying power of their large competitors.

    Examples include:

  • EPIC Pharmacies was formed in 1983 to give independent pharmacies the ability to compete on a level playing field with chain drug stores through collective buying power. Today, EPIC represents over 500 independent pharmacies in seven (7) mid-Atlantic states.
  • Independent Pharmacy Cooperative, based in Sun Prairie, Wis., has more than 1000 affiliates and 4,000 members. It is the largest purchasing organization owned by independent pharmacies. It negotiates rebates with suppliers on prices for pharmaceuticals and over-the-counter products.
  • State Pharmaceutical Co-ops and Buying Groups

    As the cost of prescription drugs has skyrocketed, state governments are forming purchasing cooperatives and multi-state buying groups to leverage their buying and negotiating power with drug manufacturers. Whether organized as co-ops or government programs, several require eligible members to pay a fee to join the co-op and benefit from the lower prices negotiated by the co-op.

    The programs allow states to help seniors, low-income residents and the uninsured to buy prescription drugs that are not covered under federal Medicare and Medicaid programs. Some programs, like the Texas Interagency Council on Pharmaceuticals Bulk Purchasing, use the state's bulk buying power to negotiate lower pharmaceutical costs for state agencies that buy prescription drugs. The New England Tri-state Coalition is a purchasing group for the states of Vermont, Maine and New Hampshire that negotiates price discounts and rebates with manufacturers.

    For more, visit the National Governors Association Center for Best Practices.

    Health Insurance Purchasing Cooperatives

    Health insurance purchasing cooperatives allow small businesses, typically operating within the boundaries of a particular state, and small municipalities to band together to negotiate for improved health insurance coverage for employees.

    While some HIPCs have been successful, some studies indicate that they face substantial barriers to offering their members better prices on health insurance. This is attributed to a variety of factors: state regulation that sets standards for premiums limiting the cost savings that can be negotiated; disinterest in, or, in some cases hostility among health plan providers toward the cooperatives; ability to attract only the smallest employers; and inadequate economies of scale—the co-ops are too small to leverage sufficient negotiating power.

    Successful examples include:

  • PacAdvantage is the country's largest non-profit small business health insurance purchasing cooperative, serving employers with 2 to 50 employees, and offering a wide variety of health plan options to some 150,000 people.
  • The Council on Smaller Enterprises, Cleveland, Ohio, a purchasing co-op for area businesses, provides its small business members with access to 25 different health plans and allows employers to offer five (5) to its employees. The co-op estimates it saves small businesses some $45 million annually in premium costs.

Worker-owned Cooperatives

Worker-owned cooperatives have emerged largely in the home healthcare field, where employees are poorly paid and turnover is high, producing quality reductions. Worker-owned home health care cooperatives offer better pay and ownership to their employees, resulting in improved living standards for health care worker-owners, higher worker retention rates, and improved quality.

Examples include:

  • Cooperative Care, Wautoma, Wis., is an employee-owned cooperative of caregivers providing personal and home care services in Central Wisconsin. It has been recognized by Harvard University's John F. Kennedy School of Government for its innovative approach to home health care.
  • Cooperative Home Care Associates, South Bronx, N.Y., is a 600 member, worker-owned home health care service that offers worker-owners higher pay and ownership benefits. It provides home health care aides on a contract basis to large health-care providers and has served as a model for the development of other worker-owned home health care cooperatives.
  • I Am Unique Special Care and Case Management Inc., Raleigh, N.C., is the nation's first nursing cooperative, offering private nursing services, in-home aid, personal care, rehabilitation and other services.