Provider-Sponsored Health Plans (PSHPs)

Direct-to-employer health care programs continue to develop as a model to streamline care delivery and reduce costs. Twelve years after rolling out its initial direct-to-employer products, Cleveland Clinic recently launched a Musculoskeletal Center of Excellence and a Bariatric Center of Excellence.
The American Hospital Association looks forward to working with CMS on implementing the good faith estimates and advanced explanation of benefits (EOB) required by the No Surprises Act.
Just months after ending its Haven collaborative with Amazon and Berkshire Hathaway to cut employee health care costs and improve quality, JPMorgan Chase is banking on a new model. It plans to invest up to $250 million in a new venture — Morgan Health — to improve outcomes and promote health equity.
Letter to Centers for Medicare & Medicaid Services, expressing deep concerns regarding a series of UnitedHealthcare health plan coverage policies.
Physician practices spend an estimated $2.76 billion a year updating provider directory information for health plans, according to a survey released yesterday by CAQH.
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…
In this study, the research team sought to compare the performance of provider-sponsored health plans (PSHPs) versus the three largest nonprovider- sponsored health plans (NPSHPs) in their markets, based on publicly reported data for the period 2011-2013. The findings indicate that the performance…