Partners-Care New England merger likely to raise premiums

A study from the Rhode Island Office of the Health Insurance Commissioner said the state’s residents would see increases in insurance premiums if Boston-based Partners Healthcare acquires Care New England, thanks to Partners likely using its regional market clout to gain better prices from insurers. 

The proposed acquisition has reached the point where the systems have agreed to enter into a definitive merger agreement—and possibly include Lifespan, Rhode Island’s largest health system. According to health insurers interviewed by the commissioner’s office, Partners would then ask for higher rates.

“Our experience with Partners tells us they like to solve problems with revenue solutions,” said one insurance executive in the report, according to GoLocalProv. “They will say, ‘Hit this price point or we are out of your network—including the whole Massachusetts network.’”

The insurance execs also implied Partners has “been on good behavior” on asking for rate increases in recent years in order to avoid closer scrutiny in Massachusetts and wouldn’t act the same way in a new market where prices are lower. In one example, an interviewee said Partners physician organizations in Massachusetts are up to 50 percent more expensive than the fee schedule for a typical Rhode Island practice.

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

When regulating AI-equipped medical devices, the FDA might take a page from the Department of Transportation’s playbook for overseeing AI-equipped vehicles. These run the gamut from assisting human drivers to fully taking the wheel. 

Kit Crancer, RBMA board member, speaks with Radiology Business about key legislative developments on the Hill that will affect the specialty. 

California-based Acutus Medical has said its ongoing agreement to manufacture and distribute left-heart access devices for Medtronic is the company's only source of revenue.