Disney bypassing insurers to offer HMO plans with Orlando Health, Florida Hospital

The Walt Disney Company will contract directly with two of the largest health systems in Central Florida—Orlando Health and Florida Hospital—to offer narrow network plans to its more than 70,000 employees in the region.

The Orlando Sentinel reports the direct contracting plans would be the first of their kind in the region. Two health maintenance organization (HMO) plans would be offered: one limited to Orlando Health physicians, practices and hospitals and the other limited to Florida Hospital’s network. The company would continue to offer a Cigna HMO plan to employees who don’t have easy access to either health system’s network where they live, along with two other Cigna plans with larger networks and higher deductibles.

The goal is to control costs for the company’s employees at the Walt Disney World Resort. By the region’s largest employer contracting with the health systems with the largest market shares in the area, independent practices argue they’ve lost patients and may lose even more if other large employers follow Disney’s lead.

“We've had so many patients who have expressed frustration that they didn't understand what they signed up for,” said Edwin DeJesus, MD an infectious disease physician at the Orlando Immunity Center. “It wasn't very well-explained. … It's not until they come to the office and we can't take their insurance.”

Read more at the link below:

""
John Gregory, Senior Writer

John joined TriMed in 2016, focusing on healthcare policy and regulation. After graduating from Columbia College Chicago, he worked at FM News Chicago and Rivet News Radio, and worked on the state government and politics beat for the Illinois Radio Network. Outside of work, you may find him adding to his never-ending graphic novel collection.

Around the web

Compensation for heart specialists continues to climb. What does this say about cardiology as a whole? Could private equity's rising influence bring about change? We spoke to MedAxiom CEO Jerry Blackwell, MD, MBA, a veteran cardiologist himself, to learn more.

The American College of Cardiology has shared its perspective on new CMS payment policies, highlighting revenue concerns while providing key details for cardiologists and other cardiology professionals. 

As debate simmers over how best to regulate AI, experts continue to offer guidance on where to start, how to proceed and what to emphasize. A new resource models its recommendations on what its authors call the “SETO Loop.”