Cone Health in Greensboro has received a state license to sell health insurance, and it's in the process of receiving approval from the CMS to offer Medicare Advantage plans. “We think that a big part of that transformation is being able to integrate the financing and delivery of healthcare,” said Jim Roskelly, Cone's executive vice president of strategic development.
The early success of Cone's Medicare accountable care organization gave executives confidence that they could enter the Medicare Advantage business. The ACO “proved to us that we could be more successful in a risk-based contract approach,” Roskelly said.
Charlotte-based Carolinas HealthCare System said it has no immediate plans to enter the insurance business. But Carolinas CEO Michael Tarwater said his system is changing how it works with insurers, participating in a narrow-network product with Blue Cross and Blue Shield of North Carolina and also in bundled payment programs for cardiovascular procedures with employer health plans.
Mission Health, based in Asheville, said it would prefer to build partnerships with established insurers. “But that is not to say that we're ruling it out,” said Marc Malloy, a senior vice president at Mission.
Cone Health expects to start enrolling Medicare members this fall. “If we have covered lives in the thousands, we'd be very happy with that,” Roskelly said.