Monday, December 17, 2012

Health Insurance, Blurring the Lines

Seems like these days everyone wants to be in the health insurance business. The folks in DC are scrambling as fast as they can to earn your business via Obamacare and now hospitals want to be your BFF when it comes to insurance.
Piedmont Healthcare and WellStar Health System, two powerful medical organizations, are moving into a new realm: health insurance.
The hospital systems intend to create a health plan that will offer Medicare Advantage and commercial insurance in 2014, as well as serving the two organizations’ employee base that, with their families, exceeds 35,000.
The insurance plan follows the announcement last month that Piedmont and WellStar had formed a collaboration to develop health care delivery models.
By commercial insurance I assume they mean major medical coverage on a group or possibly individual basis. They may or may not be gearing up to offer coverage to more than just their employees. The article seems to hint they will target local (Atlanta) employers.
I find it odd that a hospital system would want to jump into the fray now, with Obamacare and exchanges a little more than 12 months away. Health insurance carriers are hesitant to do too much until they get more direction from HHS, so why would a hospital be in a better position to gear up for this new direction?
Adding Medicare Advantage plans is even more puzzling. Not only are there compliance issues at the state level but you must get approval from CMS as well.
Makes me wonder if they really understand what they are getting in to.
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