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Insurance Landscape | Health Insurance Companies Expanding Into Patient Care

 The trend of insurance companies owning or operating medical or dental treatment companies is part of a broader vertical integration strategy. This integration allows insurers to control more aspects of patient care, from insurance to the provision of services, ultimately aiming to improve efficiency, care coordination, and cost management. Here's a look at some prominent examples:

1. UnitedHealth Group:

  • Optum: UnitedHealth Group, through its subsidiary Optum, owns and operates a vast network of medical practices, urgent care centers, surgery centers, and other healthcare facilities. Optum is one of the largest healthcare providers in the U.S.
  • Dental Services: UnitedHealth also provides dental insurance through its UnitedHealthcare brand but doesn’t typically own dental practices directly like it does with medical practices.

2. Cigna:

  • Cigna Medical Group: Cigna owns and operates medical clinics through the Cigna Medical Group, which provides primary care, specialty care, and other services.
  • Dental Insurance: Cigna offers dental insurance through its Cigna Dental division but, similar to UnitedHealth, typically partners with existing dental providers rather than owning them directly.

3. Humana:

  • Medical Clinics: Humana has invested in owning and operating primary care centers, especially through its joint ventures like Partners in Primary Care and Conviva Care Centers.
  • Dental Services: As discussed earlier, Humana has expanded its dental offerings, particularly through Medicare Advantage plans, but like other insurers, they typically partner with dental providers rather than owning practices directly.

4. Anthem (Elevance Health):

  • CareMore Health: Anthem owns CareMore Health, which operates medical clinics focusing on senior care and chronic disease management.
  • Beacon Health Options: Anthem owns this behavioral health company, integrating mental health services.
  • Dental: Anthem offers dental insurance, but, like most insurers, it doesn’t typically own dental practices.

5. Aetna (CVS Health):

  • MinuteClinic: Through its parent company, CVS Health, Aetna is connected to MinuteClinic, which provides walk-in medical services.
  • Dental Insurance: Aetna offers dental insurance, and while CVS Health owns the retail pharmacy chain, the dental services are provided through partnerships rather than ownership of dental practices.

6. Kaiser Permanente:

  • Fully Integrated System: Kaiser is somewhat unique in that it operates a fully integrated system where the insurance plan, medical providers, and hospitals are all part of the same organization. Kaiser directly employs physicians and operates its own hospitals and clinics, including some dental services in certain regions.

7. Dental-Specific Examples:

  • Delta Dental: While Delta Dental is primarily an insurer, some regional Delta Dental plans have explored closer integration with dental practices through partnerships or by providing support services to practices.
  • Aspen Dental: Though not owned by an insurance company, Aspen Dental partners with some insurers, offering a model where they own and operate practices across the U.S. This is more common in the dental field, where Dental Support Organizations (DSOs) like Aspen play a significant role.

Summary

The trend is more common in the medical field, where companies like UnitedHealth, Cigna, and Anthem own and operate healthcare facilities. In dentistry, while insurers like Delta Dental and others provide insurance, they typically do not own dental practices directly. The exceptions are usually through partnerships, joint ventures, or integrated care models.

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