Madison area providers explore partnerships

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Two health systems and their affiliated insurance companies are exploring a strategic partnership in Wisconsin. This is yet another example of the trend of consolidation among health care providers and insurance companies.

UW Health and UnityPoint Health announced two non-binding letters of intent regarding a future joint operating agreement last month. One letter describes a plan to “create an integrated clinical enterprise with a shared strategic direction.” The second letter describes a possible combination of ...

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Carrier megamerger now in doubt

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Eleven months ago four of the country’s largest health insurance companies announced two merger plans to consolidate in what would be among the largest transactions in U.S. history. In early July 2015, Aetna agreed to purchase Humana for more than $37 billion. Later that month, Anthem agreed to purchase Cigna for more than $54 billion.

The merger agreements must be approved by state insurance officials and federal anti-trust regulators. ...

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New Provider-Carrier Partnerships Expand Across Wisconsin

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The first four months of 2016 have already seen three new partnerships announced between Wisconsin health systems and insurance companies. Looking down the road, it appears that provider-led health plans may soon become a major force in Wisconsin health insurance.

In January, Aspirus and WPS Health Solutions announced that they are forming a new health insurance company in north-central Wisconsin that will be called Aspirus Arise Health Plan of Wisconsin. In April, Anthem Blue Cross and Blue ...

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Aetna-Humana merger drives fee-based model

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With Aetna poised to acquire Humana in 2016, industry observers have noted how industry consolidation generally and Aetna’s growing market share in particular will lead more intermediaries to adopt a fee-based compensation model. Although fee-based compensation for intermediaries is not a new concept, it is far less common than traditional commission based compensation. However, it appears increasingly likely that fee-based compensation will become much more widespread in the coming years.

Traditionally, insurance agents and brokers have been paid for ...

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Aetna Poised to Purchase Humana

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Aetna announced plans on Friday to make the largest acquisition ever in the history of the insurance industry. Aetna, the third largest health insurer by revenue, intends to acquire the nation’s fourth largest health insurance company, Humana, for more than $37 billion in stock, cash, and debt. A combined Aetna-Humana would bypass Anthem to become the second largest insurer by revenue and total membership. The deal would also establish Aetna as the largest provider ...

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Carrier Consolidation to Continue

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The top of the health insurance industry is poised to become an even more exclusive club. In recent weeks, news has broken that the nation’s five largest health insurance companies (UnitedHealth, Anthem, Aetna, Cigna, and Humana) are jostling to acquire a major competitor or be acquired by one. It appears that it is only a matter of time before another round of health insurance industry consolidation commences, potentially raising anti-trust concerns.

Over the weekend, Anthem announced plans to acquire ...

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Large Employer Market Consolidates Again

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The Business Health Care Group (BHCG) will terminate it’s long term partnership with Humana early this year and will now offer members health insurance with United Healthcare effective January 1, 2016. BHCG has 107,000 members, including some large employers in southeastern Wisconsin.  United Healthcare was awarded the contract after Humana began moving away from providing its services in the large group market.

United Healthcare will be providing a premium designation plan to BHCG members.  This plan gives members a financial incentive to get care from physicians that ...

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