Growing Network of U.S. Health System-Owned Insurance Plans Enhances Integrated Care
U.S. health systems are increasingly establishing or expanding their own health insurance plans to improve care coordination, patient outcomes, and cost efficiency. These health system-affiliated health plans often combine local provider networks with national payer capabilities. Examples include Allina Health Aetna in Minnesota, AdventHealth and Health First in Florida, and Aspirus Health Plan in Wisconsin, among others.
Many of these plans offer a range of products, including commercial employer plans, individual and family coverage, Medicare Advantage, Medicaid, and CHIP, tailored to meet the needs of diverse populations. Plans often include supplemental benefits such as dental, vision, fitness reimbursements, and care coordination services that leverage integrated provider networks.
For instance, Banner Aetna blends the payer-provider models offering virtual care and innovative plan designs, while Baylor Scott and White Health Plan covers nearly half a million members with a fully integrated system of hospitals and physicians in Texas. Some plans like Cook Children's Health Plan and Driscoll Children's Health Plan focus specifically on pediatric populations and Medicaid-managed care.
Provider-sponsored plans like Geisinger Health Plan, HealthPartners, Kaiser Permanente, and UPMC Health Plan operate integrated delivery networks, enhancing coordinated care and wellness initiatives. These plans serve millions across multiple states, spanning commercial, Medicare, and Medicaid lines.
Nonprofit health plans affiliated with regional systems such as Presbyterian Health Plan in New Mexico, Priority Health in Michigan and neighboring states, and Select Health (Intermountain Health) in Utah provide a mix of insurance products with extensive provider networks.
Other regional health system plans include Jefferson Health Plan in Pennsylvania, Sutter Health Plan in California, and Sharp Health Plan in San Diego, each offering a blend of HMO, PPO, and Medicaid products with an emphasis on network integration and digital tools for member engagement.
The landscape demonstrates a shift towards integrated care models facilitated by provider-sponsored insurance entities. These plans aim to align clinical services with payer functions, promoting improved health outcomes and operational efficiencies.
Health plans affiliated with large integrated delivery systems generally focus on Medicare Advantage, Medicaid managed care, employer-based coverage, and individual marketplace options. Their provider networks often include thousands of physicians, specialists, and multiple hospitals.
Emerging plans like St. Luke's Health Plan in Idaho and Peak Health (WVU Medicine) in West Virginia exemplify newer market entrants focusing on local coordination and transparent benefits. Overall, these health system-owned and affiliated health plans represent a growing trend in the healthcare insurance sector, reflecting strategic collaborations between providers and payers.
The compilation of these plans by Becker's Healthcare highlights notable organizations but is not exhaustive or an endorsement. The expansion in system-owned health plans further underscores the evolving insurance market dynamics driven by integrated care delivery models and regulatory considerations.