Study Looks At WellPoint’s Post-ACA Strategies

The nation’s largest commercial insurer, WellPoint Inc., is transforming its products-and its provider relationships to prepare for the new healthcare market in 2014, according to an analysis by HealthLeaders-InterStudy. WellPoint has narrow provider networks in all 14 Blue Cross Blue/Shield affiliate states. This strategy supports narrow-network plans in the healthcare exchanges, which opened for enrollment October 1, 2013.

WellPoint’s previous model was based on broad networks that included almost every local provider. Because of the changes in healthcare reform, the company is offering smaller, cost-effective network options, said HealthLeaders-InterStudy Principal Analyst Paula Wade. Depending on how the larger commercial market responds to the narrow-network designs,hospitals outside of the narrow networks could face some real strain.

These narrow-network plans offer lower premiums for individuals and groups by excluding high-cost providers. The strategy allows these low-cost networks to be offered in its other commercial products. WellPoint is already offering narrow-network products and tiered-network products in its largest market, California.

WellPoint also rewards providers for managing the healthcare of patients with chronic conditions and keeping patients compliant with their medications.  For more information, visit www.hl-isy.com.

Last Updated 10/14/2020

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