While regional payers have fewer members, their concentration in one area gives them the same power, if not a leg up, in negotiations with local providers, according to an August Fitch Ratings report shared with Becker's Hospital Review.
For the review, Fitch analysts looked at how operations at four regional payers — Kaiser Foundation Health Plan, Health Care Service Corp., Blue Shield of California and Blue Cross of Idaho — compared to larger competitors.
Despite their smaller enrollment, the organizations still sufficiently spread risk across their populations, and they usually have "robust regional provider networks," Fitch said.
However, size can come with its disadvantages. For one, regional plans typically don't have as many resources to invest in data and new technology as larger insurers. Others struggle with branding. Fitch did note that HCSC, Blue Shield of California and Blue Cross of Idaho benefit from their link to the larger Blue Cross Blue Shield brand.