UnitedHealth health insurance subsidiary United Healthcare, and medical care provider subsidiary Optum are rolling out a combined package of medical care and health insurance as they merge health benefits and provide value-led healthcare services in the USA. IMTJ analyses this move to combine healthcare and health insurance, and its potential impact on medical travel.
The plan is a pilot, to test how UnitedHealth’s UnitedHealthcare insurance business and the Optum health services will work together in the future.
The Harmony plan includes providers from UnitedHealth’s OptumCare as well as medical care providers in southern California such as HealthCare Partners, Sharp HealthCare and UC San Diego Health.
The new health plan in southern California is an accountable care platform that now serves 1.5 million people through value arrangements.
Value models put doctors and hospitals under an umbrella that is paid based on health outcomes and performance of their patients. The goal is to make sure patients are getting the right care at the right time and in the right amount. This is contrary to the fee-for-service approach of insurance payment to doctors that is based on volume of care delivered.
UnitedHealth’s Optum unit has built up a menu of healthcare services, from surgical care to treatment in a doctor’s office and urgent care centre. Health insurance products offering this collection of medical care are only just appearing.
United and Optum has a SignatureValue Harmony Network that offers a broad selection of physicians located across five Southern California counties: Los Angeles, Orange, San Bernardino, Riverside, and San Diego.
The Harmony insurance plan provides a seamless experience by uniting care and cover, achieving 20% savings for people as compared to UnitedHealthcare’s comparable coverage offers.
In other healthcare and health insurance combinations across the USA, CVS Health, which has drugstores and retail clinics, now owns Aetna, the nation’s third-largest health insurer. CVS Health will be offering Aetna health plans featuring CVS medical providers, that will offer a financial incentive for health plan subscribers to choose such plans.
Leading insurer Humana has also been signing deals with multiple providers, including drugstore giant Walgreens Boots Alliance.
Away from the USA, global insurers Allianz and Axa are among those who now offer both insurance and healthcare, increasingly on a combined basis.
IMTJ analysis
The idea of mixing healthcare and health insurance together is that it locks out competing insurers and healthcare providers. It is part of a move by the big US and global players to become a one-stop-healthcare shop for customers. Chinese giant Ping An, for example, goes a step further and adds technical and Internet services as well.
The risk for medical travel is that as value-based models combining healthcare and insurance develop globally, medical tourism could get pushed to the fringes.
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