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NY Hospital Joins Payer Fray

Rene Letourneau, for HealthLeaders Media, August 5, 2013

"We don't expect to be the biggest in the marketplace," Gold agrees.

What Gold does expect is that the line of CareConnect products will undercut the competition when it comes to price. An individual CareConnect plan through the exchange will cost about $420, roughly 10% less than the next lowest priced plan on the market, according to Gold.

"Our price point is highly competitive," he says. "We are not necessarily going to pay ourselves more. If anything, we expect our premiums will be lower than others on the market, and we will pay ourselves a reasonable rate."

During its first year, CareConnect will have about 4,500 to 5,000 in-network physicians, including primary care doctors and specialists that are both employed and independent. One financial advantage of operating its own health plan is the ease with which the hospitals and physicians will be paid for their services, Gold says.

"I would say one of the secondary or tertiary byproducts of having our own plan is it will make getting paid and paying our docs and the docs who work with us much, much, much simpler. It will also make it much, much, much easier for consumers. There will be less hassle for everyone involved. … We think by owning our insurance company, we can do that. It's not the reason for doing this, but it's a byproduct."

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