Editor’s Note: For payers, developing a new, collaborative payer provider model reinvents the role of payers as provider allies. BHM understands the special bridge between payers and providers because our they both are clients. Click HERE and discuss how BHM helps reinvent payers and build relationships.

Collaborative Payer Provider Model Enhances Primary Care

The three largest private health insurers held 80 percent or more of the employer market in 2015-16, according to a Government Accountability Office analysis.

The GAO used enrollment data from 2015-17 that health insurers reported to CMS and compared the data to 2011-14 enrollment figures. Some data sets also included other state and federal numbers.

The health insurers with the largest share in each state and the District of Columbia’s large group market in 2016:

Alabama — Blue Cross and Blue Shield of Alabama (92.9 percent)
Alaska — Premera Blue Cross (83.9 percent)
Arizona — Blue Cross and Blue Shield of Arizona (38.4 percent)
Arkansas — Arkansas Blue Cross and Blue Shield (78.5 percent)
California — Kaiser Foundation (47.9 percent)
Colorado — Kaiser Foundation (48.5 percent)
Connecticut — WellPoint (29.8 percent)
Delaware — Highmark (69.8 percent)
District of Columbia — Aetna (37.4 percent)
Florida — Blue Cross and Blue Shield of Florida (49.4 percent)
Georgia — WellPoint (44.1 percent)
Hawaii — Hawaii Medical Service Association (68.9 percent)
Idaho — Blue Cross of Idaho Health Service (65.5 percent)
Illinois — Health Care Service Corp. (66.4 percent)
Indiana — WellPoint (61.5 percent)
Iowa — Wellmark (77.7 percent)
Kansas — Blue Cross and Blue Shield of Kansas (51.6 percent)
Kentucky — WellPoint (67.4 percent)
Louisiana — Blue Cross and Blue Shield of Louisiana (65 percent)
Maine — WellPoint (70.3 percent)
Maryland — CareFirst (65.5 percent)
Massachusetts — Blue Cross Blue Shield of Massachusetts (58.1 percent)
Michigan — Blue Cross Blue Shield of Michigan (54.9 percent)
Minnesota — HealthPartners (45.8 percent)
Mississippi — Mississippi Insurance Group (82.4 percent)
Missouri — Blue Cross and Blue Shield of Kansas City (29.2 percent)
Montana — Health Care Service Corp. (83.4 percent)
Nebraska — Blue Cross and Blue Shield of Nebraska (77.1 percent)
Nevada — UnitedHealth Group (65.4 percent)
New Hampshire — WellPoint (57.0 percent)
New Jersey — Horizon Blue Cross Blue Shield of New Jersey (54.1 percent)
New Mexico — Health Care Service Corp. (61.8 percent)
New York — Lifetime Healthcare (17.3 percent)
North Carolina — Blue Cross and Blue Shield of North Carolina (68.7 percent)
North Dakota — Noridian Mutual Insurance Company (49.7 percent)
Ohio — WellPoint (44.3 percent)
Oklahoma — Health Care Service Corp. (52.5 percent)
Oregon — Kaiser Foundation (41.9 percent)
Pennsylvania — Highmark (35.1 percent)
Rhode Island — Blue Cross & Blue Shield of Rhode Island (78.0 percent)
South Carolina — BlueCross BlueShield of South Carolina (88.6 percent)
South Dakota — Wellmark (55.1 percent)
Tennessee — BlueCross BlueShield of Tennessee (72.5 percent)
Texas — Health Care Service Corp. (45.9 percent)
Utah — IHC Group (42.1 percent)
Vermont — Blue Cross Blue Shield of Vermont (88.7 percent)
Virginia — WellPoint (48.3 percent)
Washington — Group Health Cooperative (32.6 percent)
West Virginia — Highmark (78.3 percent)
Wisconsin — WellPoint (15.2 percent)
Wyoming — Blue Cross Blue Shield of Wyoming (74.4 percent)

For payers, developing a new, collaborative payer provider model reinvents the role of payers as provider allies. BHM understands the special bridge between payers and providers because our they both are clients. Click HERE and discuss how BHM helps reinvent payers and build relationships.