A group of local physicians is betting it can do a better job providing health insurance to small central Ohio businesses than huge corporations that answer to stockholders.

About 200 doctors have studied the local market for two years, developed a business plan and hired a UnitedHealthcare executive to run their company. Physicians Assurance Corp. plans to sell insurance to companies with two to 99 employees. It is the only company of its kind in Ohio.

The last doctor-owned health-insurance company in central Ohio was the successful Physicians Health Plan, which UnitedHealthcare bought in 1992.

The partners say they will put a lot of their profit back into the company.

"Patients come before profits, which is why we're doing this," said Dr. Alice Epitropoulos, a Columbus ophthalmologist.

"We want to be able to practice medicine, and we're just fearful that the whole system will be broke."

The doctors also say they are tired of smaller reimbursements for care for which patients have to pay higher premiums.

The group says its prices will be competitive and that employers won't face double-digit premium increases. Any price increase will be explained, the doctors said.

Some of them met two weeks ago with Mary Jo Hudson, director of the Ohio Department of Insurance, about becoming a licensed company.

They want to raise $3.1 million to get going, and plan to file paperwork with the state agency in June.

The group hopes to start selling policies by late summer and insuring employees at 300 companies by January. Products will include preferred provider organizations, health savings accounts and health reimbursement accounts. The group wants all central Ohio physicians in its network, which would make it easier to contract with local hospitals.

"We can't ask Mount Carmel (Health System) or OhioHealth to give us a deal," said Dr. Brett Wheeler, a Columbus anesthesiologist and president of the group. "If they give me the same rates they give other companies, I think they'll be on board with it and I think that's fair."

Wheeler said the group doesn't plan on a profit until the third year, when its target is to insure 10,000 people.

Ohio Hospital Association spokeswoman Tiffany Himmelreich said hospitals would review any insurance company's finances before signing a contract.

Ty Pine, legislative director for the National Federation of Independent Businesses, said companies welcome health-plan competition and are encouraged by Physicians Assurance's promise of transparency.

"All (business owners) know is, these were the services provided and the premiums are larger," Pine said.

A success story is Dakotacare, a managed-care company owned by the South Dakota State Medical Association and its members since 1986.

Patients "don't have to make a choice about seeing one provider versus another or one hospital to another because all providers are in our network," said Kirk Zimmer, chief executive of Dakotacare.

Physicians Assurance wants to do the same.

"Everybody keeps talking about the (health-care) crisis, but no one has a solution to the crisis," Wheeler said. "We're trying to solve a big problem in central Ohio."

shoholik@dispatch.com

 

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