Becker's Hospital Review

63 CFO / FINANCE Hartford HealthCare, Tufts form joint venture to create insurance company: 4 takeaways By Alyssa Rege H artford (Conn.) HealthCare, which operates six hospitals across the state, is embarking on a joint venture with Watertown-based Tus Health Plan of Massachusetts to form a health insurance company, ac- cording to the Hartford Courant. Here are four takeaways about the organizations' proposed joint venture. 1. e venture, dubbed CarePartners of Connecticut, will focus on providing senior citizens who qualify for Medicare the option to purchase Medicare Ad- vantage Plans. Such plans are typically sold by private insurers and provide con- sumers' Medicare benefits with extra coverage for vision, hearing and dental. e enrollment period is expected to open this fall, with coverage starting Jan. 1, 2019. 2. Officials said the marriage of a provider and health insurer improves both parties' ability to help patients, particularly senior citizens, navigate the health- care system more easily. e organizations aim to eventually offer the plans to other healthcare providers in the state, according to the report. 3. While the proposed partnership has been approved by the Connecticut In- surance Department, CMS has yet to approve the deal. Both Hartford Health- Care and Tus Health Plan declined to comment to the Hartford Courant about their individual investments into the joint venture, but said fee schedules are still being determined. 4. Tus Health Plan President and CEO omas Croswell told the Hartford Courant the goal of such collaborations between providers and insurers is to provide patients with a less costly way to access healthcare services. "Fundamentally, what we are all trying to address — whether its Aetna-CVS, whether it's the collaboration that was announced between Berkshire Hatha- way, Amazon and JPMorgan — we're all really trying to get at a better way to access healthcare and ideally deliver better quality at a lower cost. So these are all focused on the same problem, all with a different flair." n Viewpoint: ACOs don't cut costs for the general population By Morgan Haefner W hile there are 800 to 1,000 ACOs operating in the U.S., available per- formance data of Medicare ACOs shows few will accept downside risk and "are incapable of cutting costs," Kip Sullivan, JD, a Minnesota policy expert, wrote in The Health Care Blog. Here are four takeaways from his post. 1. In his opinion piece, Mr. Sullivan writes "any- one paying attention to the research knew even before 2012 that ACOs wouldn't cut costs for a general population (as opposed to a small slice of the population that is very sick)." He points to how one of Medicare's first forays into ACOs, the Physician Group Practice Demonstration, raised costs by 1.2 percent during its five years of operation from 2005 to 2010. The program included well-known par- ticipants, such as Lebanon, N.H.-based Dart- mouth-Hitchcock Medical Center, Danville, Pa.- based Geisinger Health System and Marshfield (Wis.) Clinic. 2. Mr. Sullivan also referenced CMS' latest data on Medicare ACOs, which he said "indicate the current crop of ACOs are equally incapable of cutting costs." "The data contained in the reports indicates the ACO programs are merely breaking even, and that's only if you don't count the costs to the ACOs of doing whatever it is ACOs do," he wrote. Mr. Sullivan said of the 458 ACOs participating in CMS' Medicare Shared Sav- ings Program, the former Pioneer program and the Next Generation program, 90 percent were Track 1. This means they only accepted upside risk, as opposed to both upside and downside risk. 3. Of the eight ACOs remaining in the Pioneer program when it ended in 2016, Mr. Sullivan said data shows the ACOs only cut Medicare costs by seven-tenths of one percent in the program's final year. 4. "The failure of ACO proponents to answer the question, Why do we need both ACOs and insurance companies, is creating problems for Medicare which now has to administer three separate programs — the traditional fee-for- service program, the new ACO program, and the Medicare Advantage (MA) program," Mr. Sullivan adds. n 36% of Americans would use an Amazon health insurance plan By Ayla Ellison A mazon has shaken up the healthcare industry by launching a line of over-the-counter healthcare products and partner- ing with JPMorgan Chase and Berkshire Hathaway to create an independent healthcare company. If Amazon continued its venture into healthcare by launching health plans or providing prescription medications, many consumers would support that move, according to a recent poll by LendEDU of 1,000 con- sumers who purchased something from Amazon in the past 30 days. The survey revealed 35.8 percent of consumers would use an Am- azon health insurance plan, and 54.7 percent would trust Amazon to provide them with over-the-counter and prescription medicine. n

• Cover