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Health care provider execs tout larger insurance investments

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Health care provider execs tout larger insurance investments

As health care providers start to bear more financial risk for managing population health, they're making larger investments in commercial insurance assets to build their actuarial expertise.

Top executives touted these moves to bondholders and prospective investors this week at the JP Morgan Healthcare Conference in San Francisco.

Catholic Health Initiatives, for instance, said it is in talks to buy an unnamed commercial health plan with 70,000 members that operates in one of its current states.

The system is also using Soundpath Health, a Medicare Advantage plan in Washington state in which CHI purchased a majority stake last March, as a platform to partner with other insurers. Like many commercial payers, the health system has seen the opportunity that will come from an aging baby boomer population.

“Almost every market has a Medicare Advantage opportunity,” Chief Financial Officer Dean Swindle said.

Memorial Hermann Health System, which has about a third of the hospital market in Houston, is also developing its own health plan and plans to sell it directly to employers as well as on the federal exchange, CFO Dennis Laraway said.

Memorial Hermann launched a commercial accountable care organization with Aetna last year and also is participating in the Medicare shared savings program for ACOs.

Even systems that have been in the insurance market for some time are experimenting with new ways of selling policies.

Forced to rely on the federal insurance marketplace — which has had a rocky debut — Geisinger Health System has created its own private exchange for its health plans.

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The Danville, Pa.-based integrated delivery network is offering an online marketplace that will work side-by-side with the federal exchange, said Dr. Glenn Steele, its president and CEO. Consumers can purchase insurance from either site.

The system has been pleased with enrollment so far, Steele said, noting that 50% of new members have been younger than 50. HHS revealed last week that only one-fourth of enrollees through the state and federal exchanges have been between the ages of 18 to 34; insurers need younger patients to prevent an adverse risk pool in their exchange plans.

Beth Kutscher writes for Modern Healthcare, a sister publication of Business Insurance.