HealthLeaders-InterStudy, a leading provider of healthcare market intelligence, reports that Toledo is moving closer to being an open market with the abandonment of steerage by two large insurers and hospital systems. According to the newly released Toledo Market Overview report, as of the beginning of 2008, members of Anthem Blue Cross and Blue Shield and Medical Mutual of Ohio can go to hospitals owned by either ProMedica or Mercy Health Partners without fear of out-of-network costs. Each health plan negotiated new contracts with northwest Ohio's two major health systems in October 2007.
"With the end of steerage in this marketplace, health plans have the most to gain in the long term," states Mark Cherry, HealthLeaders-InterStudy market analyst and author of the report.
This expansion of networks allows health plans to negotiate freely with area hospitals instead of being tied to only one of the major health systems in Toledo. However, Paramount Health Care, which has more than 70 percent of fully insured commercial HMO enrollment in the region, continues to direct patients toward parent company ProMedica and not Mercy, although the health plan includes the University of Toledo College of Medicine in its network.
The new health plan environment will also allow Anthem and Medical Mutual to introduce critical aspects of consumer-driven care, such as cost and quality transparency for the purposes of comparison shopping. A souring economy should encourage employers, even unionized ones, to seek consumer- driven health plans and wellness programs, which contributes to a positive environment for insurers.
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