After years of fighting over contracts and claims payments, hospital systems and insurers have decided to “align incentives” -- the newest big trend in health care. Florida Hospital, a huge non-profit operated by Adventist Health System with tentacles throughout Central Florida, has announced a joint venture with an HMO on the Space Coast and will operate a health plan in 2014.
Health First Health Plan, based in Rockledge, is a non-profit that operates commercial and Medicare health plans, and operates a large multi-specialty physician group and four hospitals. Its record at integrating payer with provider has been highly successful, earning 4.5 out of 5 stars from the Centers for Medicare & Medicaid Services for 2013.
Florida Hospital Health System operates provider networks in 10 Central Florida counties from Tampa to Daytona Beach, with 23 hospitals, 22 urgent care centers and more than 4,000 doctors.
Executives with Florida Hospital announced that the joint venture with Health First will be formed in October, partnering with Health First Health Plans, according to the Orlando Sentinel. Starting with a Medicare Advantage plan in Volusia and Flagler counties, the new plan is forecast to add commercial health insurance and expand to nine more Central Florida counties.
Adam Powell, a Boston healthcare economist interviewed by Health Leaders Media, says the new partnership is "yet the latest in a series of narrow network plans that have emerged in response to healthcare reform."
"These plans tend to offer people high-value care delivered from a concentrated set of providers in their area," he said.
Beckers Hospital Review reports that such ventures were recently announced in California and Atlanta.