Hospitals taking scalpel to middlemen
By Wall, J K | |
Proquest LLC |
When the next enrollment season opens for the Obamacare exchange in
It's part of a national trend in which doctors and hospitals think they can do a better job of controlling costs and keeping patients healthy by cutting out the insurance middleman.
Four insurance entities sponsored by doctors and hospitals will compete on the Obamacare exchange in 2015, according to May filings with the
New to the market next year will be
They will join
"There is a blurring of the lines between providers and the insurance companies," said
The three other health insurers selling on the Obamacare exchange in 2015 will be
More than 132,000 Hoosiers signed up for 2014 coverage on the Obamacare exchange, formally known as the
That number is projected to double in 2015.
Exchange coverage is heavily subsidized by taxpayers. For 2014, 89 percent of exchange enrollees qualified for tax subsidies.
"I view it as a nice, solid addition to a book of business that we've had for 30 years,"
The concept, called population health, is almost exactly the opposite of hospitals' past strategy, which was to perform as many procedures and services as possible. IU Health Plans thinks it can use population health to keep its prices competitive even with much larger insurers, like Anthem.
"We know that the most affordable care a member can receive is the care that was made unnecessary through effective approaches that improve health," Parker wrote. "IU Health Plans chose to enter the
So far, however, it appears that the health insurers that have no connection to doctors and hospitals have been best at doing the basic blocking and tackling of health insurance: pooling and pricing risk.
In their
But PHP filed for a 46-percent rate increase. And MDwise asked for a 35-percent hike.
Executives from both PHP and MDwise hinted those rates would be adjusted - most likely downward - as they get more data about the people in their plans and how much care they are using, as well as about how government programs may cover some of their 2014 losses.
"It takes a lot of different kinds of talent and a lot of different kinds of core competencies to run an insurance company than it takes to run a hospital system," said Weixel, the Deloitte consultant.
More players on the field
In 2015, three more insurers will join the four that sold health insurance on the Obamacare marketplace this year.
New insurers
CareSource
IU Health Plans
Existing insurers
Coordinated Care
MDwise
Physicians Health Plan
Source:
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Wordcount: | 770 |
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