By Lauren Flynn Kelly
Whether they are new to the insurance market altogether or got their start on the Affordable Care Act (ACA) exchanges, many insurance startups this fall are placing their bets on Medicare Advantage.
With MA enrollment increasing each year as a percentage of the overall Medicare program and the Trump administration’s continued efforts to bolster the MA program, the time is right for these startups to pursue the market, suggests Patrick Phillips, founder and CEO of Health care technology firm Cavulus.
Some advantages these plans have over longstanding MA insurers that typically operate multiple lines of business is “they don’t have a health plan culture to overcome” and can build their own technological infrastructure from scratch to avoid gaps in operations and member touchpoints that are often created by legacy systems, Phillips adds.
Orange, Calif.-based Alignment Healthcare has remained solely committed to the MA population since it was founded and has spent the last several years building a “connected care model” that relies on technology to help improve senior care.
For example, the proprietary artificial intelligence (AI)-powered “command center,” Alignment Virtual Application (AVA), aggregates data from disparate sources every 30 minutes to catch key health indicators and triage members.
Alignment on Aug. 20 unveiled plans to double its geographic footprint and the number of plans it offers in Northern California this coming Annual Election Period.
Meanwhile, new entrant Zing Health aims to launch a physician-led MA plan in Cook County, Ill., with a focus on underserved populations and using local resources and technology to impact social determinants of health.
Zing is also working on ways to digitally support its community-based “local field care teams” that will be embedded at partner hospitals, community health centers and other locations where members receive care.