Filed Under:Health Insurance, Individual Health

ACO exchanges pop up on carrier radar

(FAA image)
(FAA image)

Carriers might be getting more serious about marrying two hot health insurance concepts — private exchanges and accountable care organizations.

Aetna Chairman Mark Bertolini gave the exchange-ACO hybrid concept buzz this week during a first-quarter earnings call.

Bertolini said Aetna plans to bolt private exchanges onto its ACO models, and give individuals and small groups the ability to use the exchanges to shop for bundles of health care services from multiple provider systems.

Aetna also wants to use private exchanges to offer a “national ACO chain” to large employers, Bertolini said.

Meanwhile, Simeon Schindelman, the chief executive of Bloom Health Corp., was out trying to promote his company’s established exchange-ACO program.

Bloom Health is working with a Minneapolis carrier, Medica Inc., to offer employers access to a choice of four commercial market ACOs.

The ACOs assume some risk but also use stop-loss arrangements to protect themselves against catastrophic losses. Medica, which is a stop-loss provider as well as a direct writer of insurance, supplies the stop-loss protection.

About half of the employees who’ve been offered a chance to use an ACO, rather than a traditional provider network, have picked the ACO, Schindelman said.

“That’s a remarkably high percentage,” Schindelman said.

Schindelman said Bloom Health is paying standard commissions to agents and brokers.

“Agents and brokers are incredibly important to the success of this model,” Schindelman said.

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