Provider-Sponsored Health Plans Negotiated Lower Prices For Health Services Compared With Traditional Insurers, 2024.

Although hospitals and insurers have traditionally operated as separate organizations, an increasing number of health systems have begun offering vertically integrated insurance plans, known as provider-sponsored health plans. We examined differences in negotiated prices for forty-six mandatory reported health care services between provider-sponsored health plans and nonintegrated insurance plans, using hospital price transparency data. Of the 639 health systems in the United States in 2023, 179 (28.0 percent) offered an insurance plan, most often Medicare Advantage plans. Across health care services, forty-four of forty-six had negotiated prices that were significantly lower for provider-sponsored health plans compared with those for nonintegrated insurance plans. These findings offer evidence that provider-sponsored health plans negotiate health care prices with their health systems differently than nonintegrated insurers do, but greater transparency in pricing and ownership is essential to fully assess the risks and benefits that provider-sponsored health plans may have for health care prices.