Insurer-Owned Clinics Are a Growing Threat to More Traditional Practices

More U.S. insurance companies, not satisfied to merely decide what care and treatments they’ll cover, and to what degree they’ll compensate clinicians, are opting to establish their own healthcare facilities in an effort to control both delivery and payment for healthcare, according to an article published recently in The Wall Street Journal. It cites UnitedHealth Group as a prime example. Through its Optum unit, UHG has been buying up practices—including urgent care centers, individual primary care practices, and surgery centers—in the Los Angeles area. And Blue Cross & Blue Shield of Texas has opened a handful of clinics, at which members will be able to get free primary care visits. That plan does include unaffiliated physicians and clinics, but patients who seek care from them will have to fork over a copay, in effect offering patients a strong incentive to stay in-house. This may be especially problematic for health systems that have been buying up existing urgent care businesses or investing in building their own, as what they may have thought was a finite marketplace is growing with a whole new category of competitor. In addition, hospital-based urgent care centers risk losing the revenue they’ve been raking in by referring patients for imaging and testing internally.