Provider-owned health plans don't offer lower premiums

Though provider-owned health plans are intented to hasten the transition from a fee-for-service payment model to value-based care, these types of plans don't seem to produce lower premiums, according to a new HealthPocket study.

The study compared premiums for 40-year-old individuals who purchased provider-owned Affordable Care Act plans versus ACA plans not owned by providers in 12 counties nationwide with both types of plans. It compared the premiums for bronze, silver, gold and platinum plans sold on the federal exchange. 

Here's a breakdown of the study:

  • Bronze and gold provider-owned plans were 13 percent more expensive than the cheapest bronze and gold plans not owned by providers.
  • The cheapest bronze plan in Bernalillo County, New Mexico was $67.79 more expensive per month than the cheapest bronze plan not owned by a provider.
  • For the most popular option offered on Healthcare.gov--the silver plan--the least expensive provider-owned plans were $27.33 per month more expensive on average than the least expensive plans not owned by providers. What's more, the benchmark cost of a silver plan is expected to rise, on average, 4.4 percent next year.
  • In eight of the 12 counties studied, the cheapest silver plan was not a provider-owned plan.
  • The cheapest gold plan was a provider-owned plan in only two of the 12 counties examined.
  • Only three of the 12 counties had provider-owned platinum plans; 10 of the 12 counties had platinum plans not owned by providers.

These results indicate that healthcare reform may not necessarily produce the imagined cost-saving results, HealthPocket concludes in its analysis. Though "with respect to provider-owned health plans, the lack of premium advantage does not call into question the value of the model altogether," it notes.

For more:
- here's the survey

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