Thursday, July 27, 2017

The Clinic and The Insurer

Not sure how this stayed under my radar, but thanks to FoIB Bill M we learn that the estimable Cleveland Clinic is about to jump into the individual medical insurance pool. And they're partnering with New York-based Oscar Health to do it:

"The venture, called Cleveland Clinic | Oscar Health ... will be available on the public exchange, off the exchange or directly through Oscar."

The catch?

They'll only be available in 5 counties in northwest Ohio.

Which, perhaps not so coincidentally, is also the home base of Medical Mutual.

Interesting. Particularly because of this:

"The Cleveland Clinic network now only is available on the exchange through a broad network offering provided by Medical Mutual of Ohio"

Hunh.


To be sure, Oscar's had its own issues:

"[F]or every dollar of premium Oscar collects in New York, the company is losing 15 cents. It lost $92 million in the state last year and another $39 million in the first three months of 2016"

As their CEO noted at the time, this is not "a sustainable position.”


Anyway, the product itself will apparently rely pretty heavily on the telehealth model, which seems like one area that carriers are starting to really embrace as an effective cost-containment strategy.

No word yet on whether or not they'll have any kind of marketing agreement with insurance agents (but smart money is on "no").
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