ACHE 2017: Provider Sponsored Health Plan Means Understanding Your Market

Guidehouse's Eric Meinkow and Christopher Kalkhof from the ACHE Congress, via HealthExec

The lines are blurring between healthcare providers and payers as more providers are sponsoring their own health plans or partnering with payers. Unfortunately for interested providers, that greater prevalence hasn’t come with any one-size-fits-all approach for making these plans succeed.

As of 2014, 108 plans cover around 18 million members in 39 states, according to Guidehouse consultants Eric Meinkow and Christopher Kalkhof.

In their presentation at the American College of Healthcare Executives (ACHE) Congress in Chicago, they said the growth in provider-sponsored health plan trend has been driven by two factors—one being greater risk being foisted upon health systems through alternative payment models, like accountable care organizations and bundled payments, and the second being consolidation among both health systems and insurers.

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