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By Modern Healthcare
Posted: July 20, 2013 - 12:01 am ET

ROSEVILLE, Calif.—Adventist Health, a California-based health system with 18 hospitals in four states, plans to seek California's approval for an insurance license before the end of the year. It would be Adventist's first insurance license, though it will be a limited license. An insurance license will better position the health system to take on financial risk for patients' care under new, global payment contracts with private insurers, Medicare and Medicaid that have emerged across the industry and under the Patient Protection and Affordable Care Act, said Jeff Conklin, Adventist Health's vice president of payer and network strategies. Adventist will seek a limited license that would allow it to enter into contracts with more financial risk, but does not allow Adventist to sell insurance directly to consumers, he said. The system joins a number of other health systems with recent deals or plans to acquire necessary state approval for health plan operations, either by seeking a license or by acquiring an insurer. Steve Nolte, CEO of Sacramento, Calif.-based Sutter Health's insurance arm Sutter Health Plus, said the system sought to gain more direct control over the delivery and financing of healthcare with its newly licensed insurance operations, which will launch its first health plans next January. Data captured by the insurer will better inform efforts to identify quality and efficiency gains, he said, which appears to be “the mission of reform.”

—Melanie Evans



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