Re­port con­firms grad­ual growth in hospi­tal-owned health plans

Modern Healthcare - - LATE NEWS - —Bob Her­man

More hos­pi­tals and health sys­tems have started or ex­panded their own health in­surance plans since the Af­ford­able Care Act was en­acted.

Hos­pi­tals view own­ing a health plan as a way to build their pop­u­la­tion health pro­grams by com­bin­ing med­i­cal claims and clin­i­cal data. A health plan also al­lows hos­pi­tals to con­trol more of the pre­mium dol­lar.

Ap­prox­i­mately 15.3 mil­lion peo­ple re­ceived their health cov­er­age through a provider-owned health plan in 2014 com­pared with 12.4 mil­lion in 2010, an av­er­age 6% an­nual in­crease in en­roll­ment over that time span, ac­cord­ing to a re­port from con­sult­ing firm McKin­sey & Co. Most of that growth came in Med­i­caid plans. Many safety net sys­tems have their own Med­i­caid plans since low-in­come peo­ple are their pri­mary pa­tients.

Med­i­caid rep­re­sents the largest busi­ness line for provider health plans. Roughly 57% of their mem­bers were on Med­i­caid in 2014, com­pared with 32% in em­ployer com­mer­cial plans, ac­cord­ing to McKin­sey. In 2010, half of those in provider-owned plans were in Med­i­caid, and 43% were in com­mer­cial plans.

De­spite the grad­ual growth in the num­ber of hos­pi­tals and providers launch­ing their own plans and their ex­pand­ing mem­ber­ship, not all plans have been suc­cess­ful. Catholic Health Ini­tia­tives told bond­hold­ers last month it was putting the brakes on its new in­surance arm, Promi­nence Health, be­cause of heavy op­er­at­ing losses. About 45% of the plans McKin­sey an­a­lyzed had a neg­a­tive mar­gin in at least one of the past three years.

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.