The Business of Healthcare Podcast, Episode 128: Alternative Health Plans: Do You Know the Risk?

In this episode of The Business of Healthcare Podcast, Becky Greenfield, a healthcare attorney and a partner at boutique law firm Wolfe Pincavage, joins host Dan Karnuta for a discussion about the complexities and risks associated with alternative health plans that are not mandated by the Affordable Care Act. Plans like healthcare sharing ministries, limited benefit plans and short-term insurance can appear similar to conventional healthcare insurance but they lack essential consumer protections like coverage for pre-existing conditions, essential health benefits, and balance-billing safeguards.

Although these plans are attractive due to their lower costs, they can can result in significant out-of-pocket expenses and limited provider networks. The conversation also highlights the challenges the hospitals face when treating patients with these plans, including confusion over payment responsibilities and financial risk due to underpayment or denials.

Karnuta is an associate professor in the Naveen Jindal School of Management’s Organizations, Strategy and International Management Area as well as director of its Professional Program in Healthcare Management.