Cleveland Clinic and Oscar Health to Offer Co-Branded, Individual Health Insurance Plans in Northeast Ohio

By a News Reporter-Staff News Editor at Managed Care Weekly Digest -- Cleveland Clinic and Oscar Health announced they will offer co-branded health insurance plans to consumers in northeast Ohio, marking Oscar Health's expansion into Ohio and Cleveland Clinic's first entree into the health insurance market with a product bearing its name (see also Oscar Health).

Beginning this fall, pending regulatory approvals, consumers in five northeast Ohio counties - Cuyahoga, Summit, Lorain, Medina and Lake - will be able to purchase new Cleveland Clinic | Oscar individual health plans. These 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.

Cleveland Clinic and Oscar Health will work together to integrate their clinical and member-facing care approaches to offer consumers a seamless, guided health care experience. Cleveland Clinic and Oscar Health aim to help members navigate the system with ease, to deliver world-class care, and to ensure quality coverage with affordable costs.

"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. "Cleveland Clinic's guiding principle of 'Patients First' shapes everything we do, including our relationships with insurers, which is why we look for insurance plans with innovative, patient-centered policies."

Cleveland Clinic and Oscar Health share values that prioritize the patient/member experience, and will work together to ensure every patient/member interaction delivers easy, guided care.

"This is a rare opportunity to work with Cleveland Clinic to deliver the simpler, better, and affordable health care experience that consumers want," said Mario Schlosser, Oscar Health's CEO and Co-Founder. "Oscar was founded to help restore the focus of our health care system on the needs of the consumers. By linking Oscar's member engagement platform to a world-renowned, physician-led health system like the Cleveland Clinic, we can align incentives and focus on the things that matter most: keeping members healthy; making it as easy as possible for them to find care when they need it, in the right clinical setting; and driving health care costs down."

Every 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 a patient/member needs to 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. Smartphone technology will help analyze their health needs, understand their care options and costs, and guide them to the right medical options.

"We are looking to build a new relationship among payers, providers and patients," said Cleveland Clinic Chief of Staff Brian Donley, M.D. "This relationship goes beyond the traditional approach of getting sick and seeing the doctor. Instead, it's about getting people the right care, at the right place, at the right time. It's about avoiding an unnecessary trip to the doctor or a stay in the hospital, whenever possible, through better patient education, better access to care, better care coordination, better behaviors and, ultimately, better health. We intend to hold this up as a solution that others can look to, as the healthcare industry continues to tackle issues of access, quality, value, experience and, of course, cost. As you take better care of people, you will begin to reduce the overall cost of healthcare."

Cleveland Clinic will continue to work collaboratively with other health insurers.

Keywords for this news article include: Oscar Health, Health Insurance.

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