Dive Brief:
- Anthem Blue Cross and Blue Shield in Wisconsin has announced a new joint venture with nonprofit health system Aurora Health Care, which operates 15 hospitals and other services in eastern Wisconsin and northern Illinois.
- The pair are forming a health insurance company called Wisconsin Collaborative Insurance Company and plan to offer a commercial insurance plan called Well Priority.
- Sales for Well Priority are slated to begin later this year and will initially be focused on medium to large-size employer groups. Plan details will be revealed over the next few months.
Dive Insight:
The deal combines Anthem's insurance expertise with Aurora's healthcare delivery system with the goal of improving care and patient satisfaction at a lower overall cost.
While Anthem describes the venture as unique, it is not far off in spirit from Anthem's previously launched Vivity collaboration with seven competing health systems in California. Modern Healthcare reported Anthem CEO Joseph Swedish last year insinuated that Vivity-like ventures might begin popping up nationwide. Last October, it was reported Vivity had enrolled 24,000 group members, up from an August 2015 membership of 13,000.
More health systems are offering their own health plans as a way to grow the business in a new era of value-based care, but the trend is not without financial risks, a recent analysis by McKinsey&Company found. It's likely the Anthem, Aurora partnership is a new venture as a result of adapting with the changing health business landscape in the wake of the ACA. Though it will be interesting to see how a regional health system-led plan backed by an insurer partnership will play out.
The McKinsey report found in its review of 89 provider-led health plans (PLHP), 40 had negative margins in some or all of the last three years.
Aurora and Anthem say Well Priority will utilize Anthem's Blue Priority network and both companies will operate the new entity as 50-50 owners. The pair tout numerous features for Well Priority, including access in 45 Wisconsin counties, a network that includes additional healthcare systems, a 24-7 Nurseline and LiveHealth Online telehealth services, and cross-system referrals among participating providers and hospitals.