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More Health Systems Becoming Payers

Posted by Aaron Groffman on Thu, Sep 05, 2013

More than 20 percent of hospitals and health systems in a recent survey said they are planning to launch a health insurance plan by 2018.

Another 34 percent of respondents said they already own health plans. The June 2013 survey was conducted by by the Advisory Board Co., a Washington, D.C.-based research and consulting firm, and included more than 100 U.S. hospitals and health systems.

Health insurance exchanges, the aging boomer population, increasing cost and reimbursement pressures and an industry-wide move toward population health are driving many health systems’ decisions to become payers, despite the risk of that move in the continually changing healthcare industry.

North Shore-LIJ Health System, a Long Island, NY-based hospital system, plans to offer its health plan called CareConnect on the state health insurance exchange beginning October 1st.

Providers that offer health insurance typically offer a narrow network composed of their own hospitals and affiliated physicians. But in order to be successful, a network must include enough facilities and physicians to provide access and member convenience. Therefore, some health systems are joining forces to create health plans with stronger networks than either could offer on its own.

For example, Piedmont Healthcare and WellStar Health System, two Atlanta-based systems, are partnering on a health plan called the Georgia Health Collaborative that will offer commercial and Medicare Advantage products starting in 2014.

If you were starting a health plan, how would your network compare to your competitors?

Tags: network growth, network providers, health insurance, Affordable Care Act, Healthcare, healthcare reform, health reform, healthcare benefits, Obamacare, health insurers

 

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