Susan Morse
President says signing up younger and healthier enrollees improves the risk pool.
Running its own health plan has allowed Marshfield Clinic to design a value-based reimbursement model that rewards physicians for quality, clean coding and cost maintenance.
While value-based care is making the move more attractive, getting an insurance product off the ground isn't the easiest.
Health system-owned plans now represent 52 percent of health insurance products, AIS said.
Insurer drew attention two years ago as the only Affordable Care Act co-op to make money from its exchange products, reporting a net income of $7.3 million in 2014.
Aetna, however, said many insurers have been forced to leave the exchanges due to what it called the instability of the marketplace.
With the Quality Payment Program under MACRA set to begin on January 1, 2017, CMS is offering clinicians four options to comply and avoid a negative payment adjustment in 2019.
The number of those with high-deductible plans did rise significantly, according to the statistics.
In 2015, patient-centered practices and hospitals received $58.9 million in care coordination and shared savings payments for reaching quality and savings goals, the company said.
The bill would require insurers to reimburse out-of-network doctors and health providers at the same rate as what they pay in-network providers.