Payer-provider vertical integration: Trends, tradeoffs, and policy options

Large national insurers—such as Humana and UnitedHealth Group’s Optum—have been rapidly acquiring physician practices, ambulatory surgery centers, and other provider entities, reshaping local health care markets. Proponents argue these arrangements can streamline care coordination, speed adoption of value-based payment, and steer patients toward lower-cost sites of service. Skeptics warn that the same consolidation may limit rival insurers’ network access, facilitate upcoding in Medicare Advantage and other regulatory gamesmanship, and erode clinical independence—raising important questions for patients, employers, and taxpayers alike.

On May 19, the Brookings Center on Health Policy will convene an expert panel to assess the evidence on payer-provider vertical integration and explore policy responses. Panelists will examine the motives, potential efficiencies, and competitive risks of payer-led integration, then outline concrete policy options—distinguishing the tools antitrust enforcers already possess from reforms that may require legislative or regulatory action.

Viewers can ask questions in advance by emailing [email protected] and on X @BrookingsEcon using #VerticalIntegration.