Datapoint

Datapoint: Oscar Plots Initial Public Offering

January 5, 2021

Insurance startup Oscar on Dec. 21 announced it is preparing an initial public offering of its common stock, “expected to commence after the completion of the SEC review process, subject to market and other conditions,” according to a press release. The insurer is undertaking a hefty expansion in 2021, bringing its individual commercial product offerings to 19 new markets. Oscar currently enrolls 416,998 members, with 95.5% enrolled in individual plans.

Insurance startup Oscar on Dec. 21 announced it is preparing an initial public offering of its common stock, “expected to commence after the completion of the SEC review process, subject to market and other conditions,” according to a press release. The insurer is undertaking a hefty expansion in 2021, bringing its individual commercial product offerings to 19 new markets. Oscar currently enrolls 416,998 members, with 95.5% enrolled in individual plans.

Source: AIS’s Directory of Health Plans

Datapoint: UnitedHealthcare, Intermountain Launch ACO

January 4, 2021

Intermountain Healthcare and UnitedHealth Group on Dec. 16 unveiled a new partnership — a Medicare Advantage accountable care organization (ACO) in Utah. United’s Medicare Advantage members who receive care from Intermountain physicians throughout Utah are eligible for the ACO. Intermountain’s physicians will receive outcomes-based payments from United, and United will also provide patient-level data on members’ previous hospital visits and chronic health needs to Intermountain’s value-based care subsidiary, Castell. United currently serves 92,111 MA lives in Utah.

Intermountain Healthcare and UnitedHealth Group on Dec. 16 unveiled a new partnership — a Medicare Advantage accountable care organization (ACO) in Utah. United’s Medicare Advantage members who receive care from Intermountain physicians throughout Utah are eligible for the ACO. Intermountain’s physicians will receive outcomes-based payments from United, and United will also provide patient-level data on members’ previous hospital visits and chronic health needs to Intermountain’s value-based care subsidiary, Castell. United currently serves 92,111 MA lives in Utah.

Source: AIS’s Directory of Health Plans

Datapoint: FDA Approves Shortened Infusion Time for Ocrevus

December 30, 2020

The FDA on Dec. 14 approved a two-hour infusion time for Roche’s blockbuster multiple sclerosis drug Ocrevus. The news comes as Novartis launches its MS challenger, Kesimpta, which is self-administered. For the treatment of multiple sclerosis, Ocrevus is covered under the pharmacy benefit for 39% of covered lives, the medical benefit for 26% of covered lives, and both the medical and pharmacy benefit for 24% of covered lives. In the pharmacy benefit, Ocrevus holds preferred status for 6% of covered lives, growing to 17% with utilization management restrictions applied.

The FDA on Dec. 14 approved a two-hour infusion time for Roche’s blockbuster multiple sclerosis drug Ocrevus. The news comes as Novartis launches its MS challenger, Kesimpta, which is self-administered. For the treatment of multiple sclerosis, Ocrevus is covered under the pharmacy benefit for 39% of covered lives, the medical benefit for 26% of covered lives, and both the medical and pharmacy benefit for 24% of covered lives. In the pharmacy benefit, Ocrevus holds preferred status for 6% of covered lives, growing to 17% with utilization management restrictions applied.

SOURCE: MMIT Analytics, as of 12/17/20

Datapoint: Blue Cross Blue Shield of Michigan Partners With Senior-Focused Clinics

December 29, 2020

Blue Cross Blue Shield of Michigan on Dec. 14 unveiled a new value-based partnership with Dedicated Senior Medical Centers, a provider-led group of six primary care centers arriving in Michigan’s Wayne County throughout 2021. Dedicated is a subsidiary of ChenMed. BCBSMI’s Medicare Advantage members will be able to access services at Dedicated’s medical centers, which focus on whole-person health, interdisciplinary care coordination and addressing social needs. BCBSMI is currently the seventh-largest Medicare Advantage insurer in the U.S., with 585,540 members.

Blue Cross Blue Shield of Michigan on Dec. 14 unveiled a new value-based partnership with Dedicated Senior Medical Centers, a provider-led group of six primary care centers arriving in Michigan’s Wayne County throughout 2021. Dedicated is a subsidiary of ChenMed. BCBSMI’s Medicare Advantage members will be able to access services at Dedicated’s medical centers, which focus on whole-person health, interdisciplinary care coordination and addressing social needs. BCBSMI is currently the seventh-largest Medicare Advantage insurer in the U.S., with 585,540 members.

Source: AIS’s Directory of Health Plans

Datapoint: Aetna Expands COVID-19 Waivers

December 28, 2020

CVS Health’s Aetna on Dec. 14 said it will waive commercial (3,268,000 risk-based lives) and Medicaid (1,586,431 lives) member cost-sharing for services related to COVID-19 vaccination. The vaccine’s cost will be fully covered for Medicare Advantage (2,661,642 lives) members. The insurer is also waiving cost-sharing for inpatient services related to COVID-19 for commercial and Medicare Advantage members through January 31, 2021.

CVS Health’s Aetna on Dec. 14 said it will waive commercial (3,268,000 risk-based lives) and Medicaid (1,586,431 lives) member cost-sharing for services related to COVID-19 vaccination. The vaccine’s cost will be fully covered for Medicare Advantage (2,661,642 lives) members. The insurer is also waiving cost-sharing for inpatient services related to COVID-19 for commercial and Medicare Advantage members through January 31, 2021.

Source: AIS’s Directory of Health Plans

Datapoint: CareFirst to Cover All COVID-19 Vaccine Costs

December 23, 2020

CareFirst BlueCross BlueShield last week said it will fully cover all costs associated with FDA-approved COVID-19 vaccine administration. The insurer advised that this policy will apply to all of its members, including self-insured plans. CareFirst currently enrolls 2,814,326 lives in Maryland, Virginia and Washington, D.C. More than half (50.4%) of its members are enrolled in a self-funded plan.

CareFirst BlueCross BlueShield last week said it will fully cover all costs associated with FDA-approved COVID-19 vaccine administration. The insurer advised that this policy will apply to all of its members, including self-insured plans. CareFirst currently enrolls 2,814,326 lives in Maryland, Virginia and Washington, D.C. More than half (50.4%) of its members are enrolled in a self-funded plan.

Source: AIS’s Directory of Health Plans