A WSJ and Jeffrey Young piece in Huffington Post reveals one of the big tensions in health care post-ACA. The articles examine a situation in Pittsburgh in the middle of a market share fight (I’ve written about that exact subject here). It seems that the University of Pittsburgh Medical Center is prepared to reject patients who are insured by Highmark, an insurer, due to Highmark’s acquisition of a struggling health group. They feel that it will boost Highmark’s attractiveness and thereby lessen market share and bargaining power.
As Young points out, agglomeration among health care entities is probably a necessary byproduct of an integrated system. Most of the health care systems health policy people seem to admire—your Kaisers, your Geisingers, your Intermountains—are integrated insurer/health care providers housing many different groups. On the other hand, big hospital groups will definitely also raise prices. It’s something that needs disentangling.
At any rate, such aggressive tactics are not something I’ve heard of the innovative providers engaging in as frequently. In fact, Geisinger usually uses the patients insured by third-parties to subsidize their innovative activity. I’m not suggesting the two situations are exactly the same, but I do think it’s worth thinking about.
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