Providers with Health Plans

Today's dynamic health care marketplace has created an environment in which some hospitals and health care systems are operating a health plan - either on their own or in partnership - as part of their strategy to advance health in their communities.

Some provider-owned health plans cover just one market segment (e.g., Medicaid managed care) and other plans offer a full portfolio of products for the public and commercial sectors. There are increasing examples of health care systems and hospitals partnering with provider and commercial health plans to offer health insurance products in local markets.

The AHA ensures that all members’ perspectives and needs, including those of members with health plans, are heard and addressed in national health policy development, legislative and regulatory debates, judicial matters, and with the media and consumers.

The AHA has launched the Provider-Sponsored Health Plan Strategic Leadership Group to help develop the AHA’s policy and advocacy agenda specific to this segment of our membership. The Leadership Group also advises the AHA on the products and tools that can assist our members in sharing and developing best practices for business and strategic issues.

Related Resources

Guides/Reports
TrendWatch Chartbook 2018 analyzes the latest in hospital and health system trends. It is produced by the AHA. These charts from Chapter 1.
Guides/Reports
Member
In January 2018, the Centers for Medicare…
Letter/Comment
Public
AHA letter to Representatives Greg Walden, and Frank Pallone expressing support for The Limited Repeal of the IMD Exclusion for Adult Medicaid Beneficiaries…
Letter/Comment
Public
AHA comments to CMS on the proposed rule amending the definition of short-term, limited-duration health insurance.
Special Bulletin
Member
On April 9, CMS issued a final rule and related guidance that will implement the standards governing health insurance issuers and the Health Insurance…
Special Bulletin
Member
The CMS on April 6 finalized a rule that will update the Medicare Advantage and Part D prescription drug programs for contract year 2019.