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Cleveland Clinic to offer health insurance
7/14/2017
 
Beginning this fall, pending regulatory approvals, Cleveland Clinic will team up with Oscar Health insurance company to offer individual health plans in five northeast Ohio counties.

The health plans are anticipated to be sold on the Ohio health insurance exchange as well as off the exchange, with coverage to begin on January 1, 2018. The organizations said they will work together to integrate their clinical and member-facing care approaches to offer consumers a seamless, guided healthcare experience.

“Together, Cleveland Clinic and Oscar Health intend to offer a different approach, one that breaks down the complexities between providers and insurers, allowing our patients to easily navigate the healthcare and health insurance systems, get the highest quality care at a reasonable price, and improve their overall health,” said Steve Glass, Cleveland Clinic’s Chief Financial Officer.

Every health plan member will be matched with both a Cleveland Clinic Care Team (comprised of a primary care provider, physician assistants, and other allied health professionals) and an Oscar Health Concierge Team (made up of a nurse and three care guides).

These clinical and concierge teams will work together across the continuum of care to ensure that each patient/member’s health and wellness needs are proactively met. Anytime patients/members seek care, they will be able to have the option of a virtual visit through Cleveland Clinic’s Express Care Online and Oscar’s Virtual Visits with no co-pay.

The two organizations also said in their press release that they would use smartphone technology to analyze patient needs and guide them to the right medical options.

If history is a reliable guide, the pairing faces an uphill struggle. The Robert Wood Johnson Foundation noted in a recent analysis few new plans have gained enough enrollees to effectively manage risk, achieve economies of scale in plan administration, or have an impact on competition and price in their local markets.

Since 2010, of the 37 new health insurance companies and five acquired health plans, only four were profitable in 2015, five have gone out of business, and two are in the process of being sold,” the foundation reported.