Dive
Brief:
- Another Medicare Advantage (MA)
payer may soon enter the market. Devoted Health of
Newton, Mass., raised $62 million and plans to
start selling MA plans in 2019.
- According
to the financial filing, the company has some big-name backers, including
former HHS Secretary Kathleen Sebelius and former Senate Majority Leader
Bill Frist, and co-founded by Todd and Ed Park, who co-founded
athenahealth.
- In other
MA news, Oscar is looking into MA. Axios reported that the company posted a job posting looking
for a person to help “support the launch of our Medicare Advantage
business." The company has since removed the job posting. Anthem
stated it will acquire America's 1st
Choice, a privately held MA plan with about 130,000 members in
Florida.
Dive
Insight:
Payers have increasingly grown more interested in the MA
market, especially given the uncertainty surrounding the ACA exchanges.
Devoted Health is a completely new entity that’s looking
to go into MA, while Oscar started by providing Affordable Care Act (ACA)
exchange plans. Oscar has since looked at other markets,
including the small businesses market.
The company lost millions last
year and appears headed that way again in 2017, so its interest in MA isn’t
surprising. The company is prepping for the long haul and tweaking its plan
where it sees fit. CEO Mario Schlosser recently told Politico that
the company's backers have said "this will take a decade or more to really
get right."
Other healthcare companies are looking to enter or expand
its MA offerings. In recent weeks, Cleveland Clinic and Anthem Blue Cross
and Blue Shield in Ohio announced they will offer a new plan called Anthem MediBlue Prime Select.
The partnership is Cleveland Clinic’s third with payers this year, including
an MA offering with Humana.
The new developments will increase competition on payers
such as Clover Health, which focuses on the MA market and has raised $425
million since 2013.
In addition to more payers interested in MA, there are
also more MA members expected next year. About one-third of those eligible for
Medicare have an MA plan, and the CMS predicted that number will
increase in 2018.
Currently, UnitedHealth Group has one-quarter of the MA
market, and Humana is a close second. There are concerns that the MA market is
dominated by only a handful of payers. The Kaiser Family Foundation said
UnitedHealth, Humana and Blue Cross Blue Shield affiliates make up 57% of MA
enrollment and the top eight MA payers comprise three-quarters of the market.
However, recent payer movement shows that more payers are interested in the MA
market, which could resolve concerns about a handful of payers monopolizing the
market.
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