New Hartford HealthCare-Tufts insurance company raises concerns

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Wednesday, Hartford HealthCare and Tufts Health Plan announced the formation of a new, jointly-owned insurer, CarePartners of Connecticut, to sell Medicare Advantage plans to Connecticut residents for next year, pending CMS approval. Hartford HealthCare includes thousands of providers in home health care, rehab services, long term care, behavioral healthcare, and five hospitals, to date. In 2015 Tufts Health Plan moved beyond their Massachusetts-based market, embarking on a similar arrangement in New Hampshire with a network of five hospitals offering coverage to employer groups. Previously, in the 1990’s, Tufts began to sell insurance in New Hampshire, Rhode Island, and Maine reaching 145,000 policyholders before shutting down in 2000 due to financial reasons.

 

Provider-insurer companies are a new but growing trend across the nation; this will be the first of this type in Connecticut. Similar concerns were raised in 2015 when ProHealth Physicians joined Optum, which also includes UnitedHealth Group. Advocates have been concerned about the growing integration between insurers and large provider health systems. Concerns include weak regulatory oversight, vertical consolidation of the market reducing competition, and confusion about where people call with complaints. While difficult contract negotiations between insurers and large health systems too often spill into the media, scaring consumers about reductions in access to care, the natural tensions also serve to control costs. If both parties are in the same entity, there are concerns that consumers will pay more and get less. There are also competitiveness concerns about provider networks’ willingness to contract with other insurers.

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