Health care system targets employers in Alabama, Indiana and FloridaReprints
MissionPoint Health Partners, an Ascension subsidiary that develops health plan networks and accountable care organizations, is going after employers' business in Alabama, Indiana and Florida.
MissionPoint, based in Nashville, Tennessee, already operates in Tennessee and includes a scattering of workplace clinics and ACOs participating in the Medicare Shared Savings Program. Now MissionPoint is marketing its network and care- and cost-management services to large employers in Evansville, Indiana, Birmingham and Mobile in Alabama, and the Florida cities of Pensacola and Jacksonville.
An increasing number of health systems are negotiating directly with employers as they compete for local market share. They also risk alienating insurance companies that they still need to negotiate with for other business.
Health care executives say the strategy allows them to better control health care cost and quality by using narrow provider networks that use information technology and incentives to coordinate care.
Health systems in some markets are expanding, buying or launching insurance companies to compete for employers' business. Others are marketing networks and benefits by working with insurers already in the market.
It appears that Ascension will do both.
Insurers that administer health plans for large employers are important, said Jason Dinger, MissionPoint's CEO. MissionPoint will work with employers' existing insurers to add the MissionPoint benefits and network as another option for employees.
But Ascension will also seek to contract directly with employers through its newly acquired health plan, U.S. Health and Life Insurance Co. The Michigan-based insurer is licensed in 20 states, and Ascension has identified large employers that fund their own insurance as a key market, Ascension CEO Anthony Tersigni said in a recent interview with Modern Healthcare.
“If there are self-insured employers in those communities we serve, we want to have the capability to develop products for them so that we're keeping their employees, who happen to live in our communities, well,” Mr. Tersigni said.
MissionPoint will operate separately from U.S. Health and Life, Mr. Dinger said.
Employers in several markets are expected to enter contracts with MissionPoint for 2017, but some may enter agreements for the coming year, Mr. Dinger said. The networks on offer include Ascension doctors but are not limited to the system's providers.
Ascension — which includes the largest U.S. not-for-profit health system, Ascension Health — has hospitals in each new MissionPoint market. MissionPoint manages the quality and cost of care for Ascension's employees in each community and will market those results to other large employers, Mr. Dinger said.
A growing strategy
That is a common strategy as health systems consider pursuing direct contracts with employers, according to health care consultants, who described the market for direct contracts as growing.
Health systems that have launched more sophisticated and aggressive programs to manage their own employees' care and medical costs are increasingly considering how to leverage that to win business, said Jordan Silvergleid, executive entrepreneur for the Advisory Board Co.
Contracts between health care systems and some national manufacturers and retailers, such as Boeing, Intel, Wal-Mart and Lowe's, are proving employers are willing to work directly with providers, said Dr. John Tam, senior vice president of Strategic Initiatives at Evolent Health.
But the demand is still limited, Mr. Tam said. A National Business Group on Health survey of 130 large employers found 2% contracted directly with providers for health benefits. “We may be a little ahead of the market on that,” Mr. Tam said.
Still, health care systems should prepare for direct contracts regardless of local interest, he said, because demand is likely to grow. Indeed, Boeing announced it would expand its direct contracting to Charleston, South Carolina, and St. Louis from Seattle, starting next year.
The most growth will occur where employers actively seek direct contracts, Tam said. Eager employers are “willing to create a winner and a loser,” he said. “That's an opportunity to grow market share in a very real way.”
Insurers, meanwhile, say they have resources and technology that can help health systems compete for employers' business.
“Cigna is actively engaged with health systems that are seeking to market their provider networks directly to employers,” said Robert Cetti, Cigna's national vice president for delivery system collaborations. The national insurer has wellness and care management programs and tools to engage doctors and patients.
Aetna works with health systems to develop networks for employers, a spokeswoman said. Health Care Service Corp., which operates Blues plans in five states, has also been in talks with health systems about direct contracts with employers, a spokeswoman said. “The more that providers compete on total cost and quality, the more overall value it can bring to our members and the health care system overall.”
Melanie Evans writes for Modern Healthcare, a sister publication of Business Insurance.