Other hospital leaders speaking at the annual conference organized by Citigroup, the American Hospital Association and the Healthcare Financial Management Association said they also plan to enter the insurance business or expand their health plans.
SSM Health Care, a St. Louis-based Roman Catholic system with 16 hospitals in four states, is “very seriously” considering expansion of its recently acquired Wisconsin plan to other states, said Dr. Gaurov Dayal, SSM's president of healthcare delivery, finance and integration.
As early as next year, 89-hospital Catholic Health Initiatives will start offering plans developed by a newly acquired Arkansas insurer, said J. Dean Swindle, CHI's chief financial officer and president of enterprise business lines. Last year, it bought a Medicare Advantage plan in Washington state. CHI leaders say they are eyeing expansion in the Advantage market, which they see as a lower-risk way of entering the insurance business.
Sacramento, Calif.-based Sutter Health will expand its year-old plan and seek a second insurance license to contract directly with employers, said its president and CEO, Patrick Fry. In New York, North Shore-Long Island Jewish Health System has projected its newly launched health plan will total 25,000 members by year-end, up from 10,000 this spring, said Michael Dowling, president and CEO of the Great Neck-based system.
Not every hospital system sees entering the insurance business as a necessary or attractive way to keep up in an industry moving toward managing the health of enrolled populations.
Ochsner Health System in New Orleans divested its insurance arm in 2004 and has ruled out a return to the insurance market, said Warner Thomas, Ochsner's president and CEO.
Still, even those without insurance arms increasingly are entering risk-based contracts with insurers and employers. By January, every contract negotiated by San Diego-based Scripps Health will include bonuses for reducing the cost of care for covered patients and penalties if costs go up, said Richard Rothberger, the four-hospital system's executive vice president and CFO.
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