Covered California tries to force progress

Covered California runs California's ACA health insurance exchange and is trying to leverage its clout to impose new conditions on insurers to improve health quality while reducing costs. Working with multiple insurance companies, it seems to be in a better position to facilitate collaboration among them; for example, one of Covered California's proposals is that insurance companies share data not only with doctors, but also with each other. Covered California is also trying to have insurance networks drop providers that are either high-cost or low-quality.

The move is bold, relative to what others in the industry have done. Part of the controversy, of course, is that people disagree about what quality means and how to assess it. Nevertheless, it seems that insurance companies have had decades to innovate in some of the ways outlined in the proposal, and probably could have accomplished more than they have. A separate objection is that the insurance networks for the relevant plans are already narrow, and that access to medical care may be inadequate if some providers are dropped from the network. It will be interesting to see if Covered California has enough market power to push these changes through.