Why AdventHealth Thinks It Can Sell an Internal Insurance Model to Employers

Why It Matters

The model shows how a health system can become a payer, potentially lowering employer health‑care costs amid rising expenses and reshaping the provider‑payer landscape.

Key Takeaways

• AdventHealth’s Select Plan grew to 18,000 members in two states.
• Plan achieved a Net Promoter Score of 92 and 92% primary‑care visits.
• Integrated network and Aetna TPA enable value‑based, low‑cost coverage.
• Health system aims to market the plan to external employers.
• Consolidated CINs provide data tools and provider alignment for scalability.

Pulse Analysis

Employer-sponsored health spending in the United States is accelerating toward its steepest annual rise in more than a decade, pressuring companies to seek cheaper alternatives. In response, AdventHealth, a nine‑state health system headquartered in Altamonte Springs, Florida, launched the Select Plan—a narrow‑network offering designed initially for its own workforce. The internal pilot enrolled roughly 11,000 employees in its home market during the first year and expanded to over 18,000 members after adding Colorado coverage for 2026. By keeping care within its clinically integrated network, AdventHealth hopes to demonstrate a cost‑effective model that can be packaged for other employers.

The Select Plan couples AdventHealth’s integrated provider network with Aetna acting as a third‑party administrator for claims, while the system’s Population Health Services Organization delivers concierge support, telehealth, and virtual primary‑care physicians. Performance data show a Net Promoter Score of 92 and 92 % of members completing a primary‑care visit by mid‑year, indicating strong engagement. The plan’s design pulls three levers—attractive benefits and premiums, a value‑based narrow network, and proactive member outreach—to drive utilization of lower‑cost services and improve health outcomes.

If the proof‑of‑concept succeeds, AdventHealth could join a growing cohort of health systems that are blurring the line between provider and payer. For employers, a system‑owned plan promises transparent pricing, aligned incentives, and access to the same data tools that the health system uses to coordinate care across its nine‑state footprint. However, scaling beyond its own employees will require navigating regulatory scrutiny, expanding provider contracts, and convincing skeptical corporate HR teams. Should AdventHealth replicate its early metrics, the model may accelerate a shift toward vertically integrated, employer‑focused health solutions.