In our healthcare ecosystem filled with disruptors, some health insurance companies are trying to take a (very big) bite.
At least, that’s what Blue Cross and Blue Shield of North Carolina (BCBSNC) is trying to do.
The state’s largest health insurer has purchased all North Carolina locations of FastMed, a national chain of urgent care clinics, according to a recent article in Becker’s.
FastMed offers preventive, telehealth, occupational health, primary, and urgent care services at clinics across North Carolina, Arizona, Texas, and Florida, according to the article. The company operates 55 facilities in North Carolina.
The health insurer’s latest acquisition just demonstrates that when it comes to industry control in the state, BCBSNC is trying to grow its footprint.
More than processing premiums and paying out claims, more health insurers like BCBSNC are infiltrating the healthcare delivery market. From investing in medical groups to home health services to pharmacy benefits managers, it feels like insurers are taking over the healthcare system from the inside out. It’s called vertical integration, and it’s led to the hyper-consolidation of health insurers, providers, and pharmacy benefit managers (PBMs), just to name a few.
When a health insurer becomes involved in almost every facet of healthcare delivery, this can cause problems. “Most health insurance markets are ripe for the exercise of health insurer market power, which harms consumers and providers of care,” according to the American Medical Association’s 2023 edition of “Competition in Health Insurance: A Comprehensive Study of U.S. Markets.”
Research indicates that vertical integration can be bad for consumers. It’s like a nasty game of Monopoly: the more of the board a health insurer owns, the more that insurer can charge for the spaces that a patient lands on. This is especially true when it comes to raising premiums. But market consolidation is also known to limit network access and shortchange provider reimbursements.
So, who knows what will come of this FastMed acquisition for BCBSNC? Until the government strengthens anti-trust laws, we’ll all hold our breath.
