All the plan-provider vertical integration literature to date

There aren’t a lot of studies and reports on the integration of health insurance plans with health care providers (meaning they’re owned by the same organization). Still, I want to keep track, so here’s what I’m aware of (I’m a coauthor on the first two):

Peer-Reviewed Publications

  • Frakt, A.B., Pizer, S.D. and Feldman, R., 2013. Plan–Provider Integration, Premiums, and Quality in the Medicare Advantage Market. Health Services Research, 48(6pt1), pp.1996-2013. I wrote about this paper here and here.
  • Johnson, G., Lyon, Z.M. and Frakt, A., 2017. Provider-Offered Medicare Advantage Plans: Recent Growth And Care Quality. Health Affairs, 36(3), pp.539-547. I wrote about this paper here.
  • La Forgia, A., Maeda, J.L.K. and Banthin, J.S., 2017. Are Integrated Plan Providers Associated With Lower Premiums on the Health Insurance Marketplaces? Medical Care Research and Review.
  • Burns, L.R., McCullough, J.S., Wholey, D.R., Kruse, G., Kralovec, P. and Muller, R., 2015. Is the system really the solution? Operating costs in hospital systems. Medical Care Research and Review, 72(3), pp.247-272.


  • Khanna, G., Smith, E. and Sutaria, S., 2015. Provider-Led Health Plans: The Next Frontier—or the 1990s All Over Again. McKinsey & Company Healthcare Systems and Services Practice.
  • Khanna, G., Narula, D. and Rao, N., 2016. The market evolution of provider-led health plans. McKinsey & Company Healthcare Systems and Services Practice.
  • Carpenter, E., 2016. Nearly 60 Percent of New Medicare Advantage Plans Are Sponsored by Healthcare Providers. Avalere.
  • Blumberg, L.J., Holahan, J. and Wengle, E., 2015. Marketplace Price Competition in 2014 and 2015. Urban Institute.
  • Pascaris, M. and Smith, K., 2015. Entrance of US not-for-profit hospitals into health insurance will continue to rise. Moody’s.
  • Goldsmith, J., Burns, L.R., Sen, A. and Goldsmith, T., 2015. Integrated delivery networks: In search of benefits and market effects. National Academy of Social Insurance.
  • McKinsey Center for U.S. Health System Reform. (2016). Hospital networks: Perspective from three years of exchanges.
  • Baumgarten, A., 2017. Analysis of Integrated Delivery Systems and New Provider- Sponsored Health Plans. Robert Woods Johnson Foundation.


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