Provider-Led Plans and Insurance Affordability

Grant: #73800

Grantee Institution: Emory University

Principal Investigator: David Howard, Ph.D.

Grant Period: September 1, 2016 - February 28, 2017

Budget: $86,825

This project is funded as part of the Robert Wood Johnson Foundation’s (RWJF) solicitation “Policy-Relevant Insurance Studies” (PRIS), which supports studies that evaluate or predict the effects of policies or policy changes related to health insurance coverage. Many plans sold in the health insurance marketplaces are owned by hospital and physician groups (i.e., “provider-led plans”). The goal of this research is to determine the impact of these plans on competition and whether these plans have lower premiums than plans marketed by traditional insurers, thereby improving affordability. Using RWJF’s HIX Compare and the Area Health Resources File, this project will identify and classify provider-led plans and compare premiums by plan type controlling for market characteristics and plan attributes. The project will shed light on the benefits of integration between providers and health plans.

Publications

Provider-Owned Insurers
The American Journal of Managed Care | September 2017