- Cleveland Clinic spokesperson Heather Phillips has hinted to Becker's Hospital Review that the provider may enter the payer market. Phillips said that applying for an Ohio insurance license is "being carefully considered."
- An insurance license can take up to 18 months to acquire, but would allow the Cleveland Clinic to market a health plan.
- Phillips said that the Clinic is working with "many insurance companies on a variety of different options."
Given the 18 months it can take to acquire a license, this isn't an overnight deal—but Phillips' frankness suggests that it has a pretty good chance of coming to fruition. Certainly the Cleveland Clinic has the risk-management expertise. It already has successful bundled payment arrangements in place with Boeing, Wal-Mart and Lowe's.
And as Becker's notes, Cleveland has a provider-driven market that offers opportunity to a payer with the brand-name recognition of the Cleveland Clinic. In Ohio, the individual market's dominant insurer (Blue Cross and Blue Shield of Ohio) had only 36% of the 2012 market (the most recent data available). Medical Mutual of Ohio clocked in at 34%, UnitedHealth at 14%—and the numbers go down from there.
Bigger and bigger provider players have started jumping into the insurance market. Last week, Ascension revealed that it intends to purchase Michigan-based US Health and Life Insurance Co. for $50 million. Its motives appear to be driven by population health concerns, something the Cleveland Clinic has to be thinking about in this move:
"The acquisition makes a lot of sense," Joseph Aoun, a healthcare lawyer with Nuyen, Tomtishen and Aoun, said of the Ascension deal. "Hospitals are now expected to manage population health and owning a health plan provides both infrastructure and a way to connect more directly with insurance purchasers."