Providers with Health Plans

Today's dynamic health care marketplace has created an environment in which some hospitals and health care systems are operating a health plan - either on their own or in partnership - as part of their strategy to advance health in their communities.

Some provider-owned health plans cover just one market segment (e.g., Medicaid managed care) and other plans offer a full portfolio of products for the public and commercial sectors. There are increasing examples of health care systems and hospitals partnering with provider and commercial health plans to offer health insurance products in local markets.

The AHA ensures that all members’ perspectives and needs, including those of members with health plans, are heard and addressed in national health policy development, legislative and regulatory debates, judicial matters, and with the media and consumers.

The AHA has launched the Provider-Sponsored Health Plan Strategic Leadership Group to help develop the AHA’s policy and advocacy agenda specific to this segment of our membership. The Leadership Group also advises the AHA on the products and tools that can assist our members in sharing and developing best practices for business and strategic issues.

Related Resources

Letter/Comment
Public
AHA urges CMS to reconsider its recent guidance to providers requiring them to document Medicare-Medicaid “crossover” bad debt in a manner that is neither…
Special Bulletin
Public
Download the Special Bulletin: CMS Releases Proposed Rule on Medicaid Drug Value-based Purchasing Arrangements   The Centers for Medicare &…
Special Bulletin
The Department of Health and Human Services (HHS) today announced that it will distribute $10 billion from the Public Health and Social Services Emergency Fund…
Special Bulletin
Public
The Centers for Medicare & Medicaid Services (CMS) released guidance on June 2 for states implementing the Medicaid Optional Uninsured COVID-19 Testing (…
Special Bulletin
Member
The Centers for Medicare & Medicaid Services (CMS) May 22 released its final rule implementing policy changes for the Medicare Advantage (MA) and Part D…
Special Bulletin
Public
The Centers for Medicare & Medicaid Services issued new guidance to states to allow temporary COVID-19-related modifications in provider payment…