Insurers in New Jersey are about to face more competition from an unlikely source as a newly named hospital group is expanding its insurance plans and selling them on the state's health insurance exchange.
Hudson Holdco, which has renamed itself CarePoint Health, is transforming itself from a small one-county hspital operator to a payer-provider organization operating throughout the state of New Jersey, according to a company statement.
As part of the transition, CarePoint will offer a Medicaid plan to be sold on the federally-run exchange available in New Jersey. The company already provides a Medicare Advantage plan, which it will soon begin marketing to seniors, reported the Newark Star-Ledger.
"Our goal is to keep patients healthy and out of the hospital. We also want to reduce the cost of healthcare in Hudson County," Spencer Baretz, CarePoint Health's spokesman, said in the statement. "Creating our own insurance plans and integrating our hospitals and healthcare services helps us do that."
Alex McLean, CEO of CarePoint Health Plans, thinks that by running both provider organizations and insurance plans, the company can better manage premiums than its competitors. For example, it can coordinate preventative and primary care to help direct patients away from the emergency room, which lowers costs and increases profits.
"Today, physicians spend an inordinate amount of time figuring out the games the insurers are playing in order to get paid," Andrew Mintz, CEO of CarePoint Physicians, told the Star-Ledger. "When you remove the tension between the health plan and the provider ... you really can find a long term efficient affordable way under which care can be provided."
But Ward Sanders, spokesman for the New Jersey Association of Health Plans, said CarePoint must recognize insurers have many roles. "If they think of insurance companies only as middlemen, they are going to find out (the companies) are more than that," he told the Newark newspaper.