Wednesday, Hartford
HealthCare and Tufts Health Plan announced the formation of a new, jointly-owned
insurer, CarePartners of Connecticut, to sell Medicare Advantage plans to
Connecticut residents for next year, pending CMS approval. Hartford
HealthCare includes thousands of providers in home health care, rehab
services, long term care, behavioral healthcare, and five hospitals, to date. In
2015 Tufts Health Plan moved beyond their Massachusetts-based market, embarking
on a similar arrangement in New Hampshire with a network of five hospitals
offering coverage to employer groups. Previously, in the 1990’s, Tufts began to
sell insurance in New Hampshire, Rhode Island, and Maine reaching 145,000
policyholders before shutting down in 2000 due to financial reasons.
Provider-insurer companies are a new but growing trend
across the nation; this will be the first
of this type in Connecticut. Similar concerns were raised in 2015 when ProHealth
Physicians joined Optum, which also
includes UnitedHealth Group. Advocates have been concerned about the
growing integration between insurers and large provider health systems. Concerns
include weak regulatory oversight, vertical consolidation of the market
reducing competition, and confusion about where people call with complaints. While
difficult contract negotiations between insurers and large health systems too
often spill
into the media, scaring consumers about reductions in access to care, the
natural tensions also serve to control costs. If both parties are in the same
entity, there are concerns that consumers will pay more and get less. There are
also competitiveness concerns about provider networks’ willingness to contract
with other insurers.
