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A number of hospital systems got into the business of insurance back in the '90s when HMOs were popular. Most found it hard to manage the financial risks involved in managing an insurance plan. But analysts say this time hospitals may have better tools to help them make it work.
"Since we've moved through the 2000s and into the current day, the data capabilities are much greater, and many hospitals are much more closely aligned with their physicians than they had been in the past, " said Lisa Martin, senior vice president at Moody's. "But there certainly are still those risks that were present back in the '90s."
One risk for North Shore-LIJ's CareConnect is that it may have priced its premiums too low. As a new insurer, it doesn't have historical data on how much medical care its members typically use. And under the ACA, insurers can no longer charge higher premiums for those with pre-existing conditions who may need more medical care.
(Read more: WellPoint says exchange enrollment ahead of plan)
While an insurance plan can help boost revenue at a time when insurers are pushing back at hospitals on reimbursement rates, it can also backfire because it puts the hospital in direct competition with other insurers.
"That really changes the dynamics of that relationship. So if it's not managed well," explained Martin, "in an extreme case that can result in a termination of that relationship, and the hospital can lose patients."
At this point CareConnect's CEO is optimistic about managing the insurance side of the business, after having exceeded early enrollment expectations.
"We thought that we would probably have 3,000 to 4,000 individual membersof which, 50 to 60 percent of them would actually pay the bill," said Murray. "We've had almost double thaton and off the exchange."
Mike Perivolaris has written the check for his company's premium, and he's hopeful his gamble on the new insurer will pay off.
"We try new things every day," he said. "We're business owners. So, we have to be a little bit daring sometimes to make good decisions."
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Hospital cuts out the middleman
This is a rendering of the proposed Legislative Office Building to be built next to the Minnesota State Capitol in St. Paul. (Courtesy of Minnesota Department of Administration)
A former state lawmaker said Monday that he will appeal a decision from earlier this month that threw out his suit seeking to stop construction of a new state Senate office building near the Capitol.
Former state Rep. Jim Knoblach said he'll ask for an expedited review by the Minnesota Supreme Court of the ruling Feb. 7 by Ramsey County District Judge Lezlie Marek.
Knoblach contends the authorization for the $63 million building and $27 million parking ramp should not have been included in the tax bill, but Marek found the building project and tax bill were sufficiently linked and dismissed Knoblach's suit.
The project has been a partisan lightning rod at the Capitol, with the Democratic majority arguing it will provide needed space for senators displaced by renovations to the Capitol, and Republicans arguing it's too expensive and hasn't received enough public scrutiny.
The project needs approval in the House Rules Committee in order to proceed.
Excerpt from:
Suit to stop Senate office building construction to be appealed
BUILDING PERMITS
Building construction permits over $10,000 in value that were approved in Boulder between Feb. 10, 2014 to Feb. 16, 2014. Listed below are: the case number; address; total project valuation; owner name; contractor (if applicable); and description.
PMT2013-04293 1064 13th St.; $744,600; 1064 13th ; AGR Building Inc; Conversion of the 34-occupant fraternity building to an eight-unit apartment building. Each unit to contain four bedrooms and two full bathrooms. Two unit types, average unit size is 1,369 square feet. Remodel of 12,400 square feet and excavation of basement area to create an 800-square-foot long-term bicycle storage/mechanical room. See LUR20103-00013 for supplemental information.
PMT2013-06932 5271 E. Euclid Ave.; $55,485; Howard Singer and B. Peckler Sing; Silver Lining Builders; Remodel to single-family dwelling to include remodel of kitchen, relocation of bath and bedroom to create master suite with walk-in, relocation of another bath, with creation of mudroom and new mechanical/laundry room. Interior bearing wall to be removed and beam to be installed in attic per engineer's specifications. Work to replace heating system included in PMT2013-06930 (flood recovery permit).
PMT2013-06947 1390 Fairfield Drive; $125,000; Justin and Michelle Kalinski; St. Vrain Builders; Two-story addition to single-family dwelling. Addition to include garage with master suite above. Scope to include reconfiguration of main level bath and small addition to main level to locate new stairs, new furnace and water heater, new kitchen island, and all assoc.mechanical, electrical and plumbing.
PMT2013-06975 4595 Squires Circle; $75,000; Seth Allen; Pine Construction Company; Remodel and addition to existing single-family dwelling. Basement addition of 114 square feet for enlarged office and bathroom. Main level addition of 160 square feet for enlarged bedroom and bathroom. Remodel of 210 square feet for new kitchen and revisions to existing baths. Includes MEP.
PMT2013-06987 3845 Lakebriar Drive; $19,500; Carolyn Paul; Harrington Stanko Construction; Reconstruction of two story deck/porch with addition of unfinished basement space below.
PMT2013-07115 850 S. 46th St.; $141,841.00; Jason and Mollie Shatek; Addition (902 square feet) and remodel (330 square feet) of existing single-family dwelling, and addition of 480-square-foot attached garage. Scope of work includes creating a second story on south side of existing home. Attached garage on ground level, with additon above. Work includes all associated MEPs.
PMT2014-00114 1642 Pearl St.; $16,975.44; Sadhu Denver ; Van Matre Construction LLC; Interior tenant remodel to add new interior partition wall to create two retail spaces with shared restrooms. Structure only, no MEP.
PMT2014-00190 3434 47th St.; $19,350; 3484 Diagonal ; TLM Construction Services LLC; Minor tenant remodel to add one new compliant bathroom, washer/dryer-laundry area, new dishwasher area in lounge, and new window opening.
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Boulder building permits: Feb. 24, 2014