Partnerships With Health Care Providers Boost Florida Blue's Profits, CEO Says

While other health insurers left the Affordable Care Act’s individual market in the state, Florida Blue is staying put and even turning a profit.

Pat Geraghty, the company’s CEO, attributes that success to partnerships and investments Florida Blue has made with health care providers.

Speaking at a health journalism conference in Orlando on Saturday, Geraghty gave one example of a diagnostic group in Pinellas County that Florida Blue purchased.

Diagnostic Medical Group needed an infusion of cash but the only investors interested were two hospitals, Geraghty said.

The group’s lead physicians were worried that investment from a hospital would come with requirements to admit patients to that hospital.

“They came to us and asked us to buy them so that they wouldn’t be, in their words, compelled to admit more patients than they thought was appropriate,” Geraghty said.

That purchase caused medical groups in marketplaces throughout the state to renegotiate with Florida Blue, Geraghty said.  

“What it did that I didn’t anticipate is all the other markets called us and said, ‘Before you buy a medical group in my city lets go back to the table and talk about how we create a better deal and a better partnership so that you don’t buy a medical group in our city,’” Geraghty said. “So it created a wave of new negotiation and we took the price of healthcare down.”

The renegotiations translated into lower rate increases in the individual market in Florida than almost anywhere else in the nation, he said.   

Other partnerships have also helped, he said.

In Orlando, Florida Blue partnered with a family health group that helped the insurer gain nearly 70,000 members.

In Miami and Tampa, Florida Blue partnered with Sanitas to open eight medical clinics, which created more competition in the marketplace. 

The insurer also partnered with a company that follows up with patients once they are discharged from a hospital. The partnership has helped Florida Blue keep hospital readmission rates down, Geraghty said.

“So we doubled down on helping people not be readmitted because it’s the right thing to do, it’s better quality of care and it’s cost effective,” Geraghty said.

The company has 1 million members in the Affordable Care Act individual marketplace. Over the past six years, the number of people insured by Florida Blue has grown from 3 million to 5 million, Geraghty said. 

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