Feb 24, 2020 - Health

Insurer-owned clinics are taking on hospitals and physicians for patients

Illustration: Axios Visuals

Insurer-owned clinics are increasingly competing with hospitals and physicians for patients, the Wall Street Journal reports.

The big picture: Doctor groups and hospitals have invested heavily in purchasing physician practices, and are worried about insurers steering patients toward their own clinics.

For example: UnitedHealth Group's Optum arm has amassed doctor practices, surgery centers and urgent-care clinics. Aetna — which was acquired by CVS — has MinuteClinics. And Blue Cross & Blue Shield of Texas has recently opened clinics with a partner company.

  • Some plans favor care received by their own providers, although how many doctors a plan owns in any given market varies greatly.
  • "It's very worrisome for hospitals," Chas Roades, a health-care consultant, told WSJ. "Suddenly, the plan you're relying on for payment is also competing with you at the front end of the delivery system."

The big picture: Plans built around their own clinics generally have more limited doctor and hospital options, but that can lower premiums.

  • It can also benefit insurers by keeping revenue all under the same umbrella.

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