St. Luke’s is joining the health insurance business. Can it become a monopolist? [The Idaho Statesman] – InsuranceNewsNet

St. Luke’s Health System, the largest health care system in the Idahois launching its own health insurance plans.

The nonprofit subsidiary, called St. Luke’s Health Plan, will bring new coverage options to residents in the west central and south central areas of the state. Enrollment begins in mid-October with plans taking effect in January.

While the new plans will not change who can receive care at the St.

So you may be asking yourself: Can St. Does Luke use his health insurance plans to refer patients to his own hospitals and clinics? And as a result you will have an unfair advantage over other providers?

When St. Luke announced the decision to enter the health insurance business in August, we asked Idaho Department of Insurance directory Dean Cameron what he thought. He said yes, St. Luke’s Health Plan certainly, and will certainly refer patients to providers within the health system’s network. But he said it is not a concern.

“We believe we have all the safeguards in place to make sure there is no monopolistic arrangement or abuse of power,” Cameron told the Statesman by phone. “They had to provide us with documentation to show that consumers would be treated reasonably if they went out of network.”

A spokesman for St. Luke’s main competitor, St. Alphonsus Health System IN Boisedeclined to comment.

Cameron said Idaho is lucky to have eight carriers that offer health insurance plans, including Blue Cross of Idaho Health Services Inc., Molina Healthcare of IdahoMountain Health Cooperation, Pacific Health Plans, Regence BlueShield of Idaho Inc., SelectHealth Inc. and UnitedHealthcare.

Plus, health insurance carriers in the state already work with providers to develop competitive contracts.

“Other states are lucky to have one health plan or two health plans,” Cameron said. “Our insurance carriers work with providers of all kinds to develop the most competitive contracts, and we want them to, because then that gives us as consumers the lowest price.”

He said that St. Luke’s agreed that it would charge all health insurers the same fee for any particular medical service, although there is nothing in the law that requires it.

Cameron said the health system has been transparent and cooperative every step of the way, but he will be careful to ensure market standards and fair trade practices are met.

“They want to be very obedient with us,” he said. “So I’d be surprised if they tried to change that.”

The health system, which has hospitals and clinics around the state, filed its notice of intent to offer health insurance in March with the state’s health insurance department. The initial coverage area will include Ada, Adams, Blaine, Boise, Camas, Canyon, cassia, Custer, Elmore, gem, GoodJerome Lemhi, Lincoln, Minidoka, Owyhee, Payette, Twin Falls, The valley AND Washington circles.

Matt Wolffpresident of the company’s health plan, believes the combination of health services and insurance will make an already complicated process smoother.

“St. Luke’s Health Plan will connect the delivery of care with the financing of care, resulting in a simpler and more affordable health insurance option for our communities,” Wolff said in a news release.

St. Luke’s Hospitals and Clinics will continue to accept most other health insurance plans, according to the release.

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