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Greg Maddrey

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Allures and pitfalls of hospitals becoming insurers


Here’s a broad national update on the growing move by providers into the insurance business.

At Premier Health, owned by Catholic Health Initiatives, Mike Maiberger, chief value officer of Premier’s five-hospital system and CEO of its Premier Health Plan, based in Dayton, Ohio, explained  his system’s intentions to Modern Healthcare:

“For us, the insurance business is just a vehicle to cover as many lives as we can in our service area with our population health initiatives.”

Modern Healthcare notes that ”Providers see the financial and quality advantages of controlling premium dollars from beginning to end and steering patients toward their services. It frees them from having to share with insurance companies any savings they generate from improved quality and efficiency.”

But, it can be scary: Once hospitals ”get into product design and pricing and all of the nuanced areas, you can get into trouble reasonably quickly,”  Greg Maddrey, a director at the Chartis Group, a consulting firm, told the magazine.

“As an alternative, some health systems such as UCSF Medical Center in San Francisco are seeking partnerships with insurers,” the publication says.



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