Maybe it's illegal for a hospital system to offer insurance in NY? I don't know. You'd think they'd be happy to cut out all the fuss around handling insurance approvals/rejections and pocket the 20% middleman cut.
More broadly, many hospitals and hospital are getting involved in the ACO (accountable care org), which gets at some of these goals, but it's not 100% clear that an ACO model can be successful (financially or for patients), and it doesn't cut out all the relevant middle-men.
Definitely not. A lot of hospitals are part of networks which are doing exactly this.
And many of the ones that aren't are entering long-term capitated agreements with insurers, which basically means they're acting as if they were insurers but without technically being one.
Capitation is still very much alive, and in fact more common than ever. It's just structured now so that it's hidden from the patient.
You may already be receiving care under capitated agreements yourself and simply not know it.