own providers.
Insurers are increasingly providing
the medical services that they cover. They are encouraging members to seek
health care at clinics, surgery centers and pharmacies that they own.
Most major insurance companies are
offering health plans that are built around their own
providers. Offering a narrow network plan that only covers an
insurer’s own providers is one way to offer low-price plans.
Aetna, which last year was purchased by CVS,
now offers many of its members free visits to CVS clinics. Blue Cross Blue
Shield of Texas recently began opening its own clinics and unveiled a new
health plan that allows members to visit them for free.
UnitedHealthCare offers a narrow network plan where
patients receive all of their primary care services from clinics owned by the
company’s subsidiary, Optum. The company says that plan costs about 20 percent
less than typical plans.
Insurers argue the discounted or free
services will save them in the long-run by boosting patient health and catching
medical issues before they become more serious and more costly.
Other medical providers are of course
less than thrilled at the prospect of increased competition. Perhaps more
worrisome than insurers setting up their own clinics is them buying up
established practices. Those practices include doctors who may have
traditionally referred patients to other specialists or hospitals but may now
be directed by their corporate parent company to send them elsewhere.
At this point, however, no insurers
are yet close to owning all of the medical services that its members need.
“Health plans want to exert pressure
on provider systems, but they don’t have a product without providers in it, so
they’re moving carefully,” Sam Glick, a health care consultant from Oliver
Wyman, tells the Wall Street Journal.
While the trend towards narrow
networks is undeniable for both individual and employer plans, so far it looks
like employers are more hesitant to embrace plans that only cover certain
services through a provider owned by the insurer. Individuals shopping for
plans on the Obamacare marketplace are more prone to pick the cheapest plan
available.
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