Hospitals expand offerings with insurance plans

New health plan ventures provide hospitals with clinical, claims data
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The line between provider and payer continues to blur, with more hospitals offering their own health insurance plans, The Wall Street Journal reported.

The trend can now be seen in Atlanta, where Piedmont Healthcare and WellStar Health System join a growing list of health systems building insurance coverage around their own networks to create seamless care and cost-savings.

New York-base North Shore-LIJ Health System, Washington and Baltimore-based MedStar Health, Ford Health System in Detroit, UPMC in Pittsburgh, Sentara Health Care in Norfolk, Va., and Inova Health System in Falls Church, Va., all have insurance entities, as well, FierceHealthcare previously reported.

Hospitals are embracing the role of insurer, hoping to gain direct access to clinical data, claims data, lab results and pharmaceutical data that provide a full picture of patients.

"It's so much better for us to have, at least, for a slice of our business, a total picture as to what's going on," said Peter Anderson, a senior vice president at California's Sutter Health, which also plans to start selling health plans.

For hospital systems not ready to jump into the insurance business, they can continue to join narrow networks, create partnerships that involve jointly owned health plans, and collaborate in integrated accountable care organizations.

In addition to insurance products, hospitals also have been adding in-house pharmacies. The hospital-based pharmacies create convenience and make sure patients leave with their medications and understand the side effects and dosages to improve adherence.

For more:
- read the Wall Street Journal article

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