Preliminary Results of AIS’s Health Plan Survey Show Continued Growth Among Provider-Sponsored Plans

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In preliminary results from Atlantic Information Services’ annual survey of health plans, AIS’s in-house researchers have identified 270 provider-sponsored plans, 53% of the health plan records in the forthcoming AIS’s Directory of Health Plans: 2016.

Research currently being conducted for Atlantic Information Services, Inc.’s (AIS) Directory of Health Plans: 2016, to be published in June, is revealing continued growth among provider-sponsored plans. With 270 provider-sponsored plans identified, these entities now represent 53% of the health plan records in the Directory, compared with 50% in the 2015 edition. An online version of the Directory will be accessible in May.

According to AIS researchers, the biggest growth areas for provider-sponsored entities are commercial risk plans, including those offered on public exchanges. Of 40 new plans identified for the 2016 Directory, 23 are provider-sponsored plans. The majority (12) of the new provider-sponsored entities were created exclusively to serve new Medicare-Medicaid dual-eligibles initiatives, particularly in New York, Michigan and North Carolina. Seven are new Medicare Advantage plans, four of which are owned by Prominence Health Plan Services, Inc., a subsidiary of Catholic Health Initiatives. Researchers have also found that exchange enrollment has doubled since last year for provider-sponsored plans reporting to date, while other plans report more volatility individually and fairly flat exchange enrollment as a group.

Three new provider-sponsored plans have been introduced that are taking on the commercial risk markets:

  • Crystal Run Health Plans, established by Crystal Run Healthcare, offers commercial insurance to individuals and groups in New York, including an Essential Plan and a Medicaid plan.
  • Premier Health Plan is serving Ohio residents with individual and group plans, as well as a Medicare Advantage plan and dual-eligibles SNP plan. It offers individual plans on the Ohio exchange.
  • Zoom+ Performance Health Insurance offers individual and group coverage in Oregon, and participates on that state’s exchange.

With surveys collected so far from half of all U.S. health plans, AIS researchers have found that among provider-sponsored plans, 78% have increased membership, adding a net of 1.2 million members. This represents an increase of 11% in membership, compared with non-provider-sponsored entities — those plans that have submitted surveys at this point have netted a 4% increase in membership. Some of the fastest growing provider-sponsored plans are in both the public exchanges and Medicaid markets, such as UPMC Health Plan in Pennsylvania, Healthfirst in New York and HealthPartners in Minnesota. Some Medicaid-only provider-sponsored plans with big gains include Family Health Network in Illinois and University Health Care Inc., dba Passport Health Plan in Kentucky.

For more information, and to pre-order AIS’s Directory of Health Plans: 2016, visit

About AIS
Atlantic Information Services, Inc. (AIS) is a publishing and information company that has been serving the health care industry for nearly 30 years. It develops highly targeted news, data and strategic information for managers in hospitals and health systems, health insurance companies, medical group practices, purchasers of health insurance, pharmaceutical companies and other health care organizations. AIS products include print and electronic newsletters, databases, websites, looseleafs, strategic reports, directories, webinars and virtual conferences. Learn more at

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Susan Namovicz-Peat, Director, Directories and Databases Division
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Atlantic Information Services, Inc.

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