NJ health care giants team with Horizon to launch their own Medicare Advantage plan

New Jersey's health care giants are teaming up to sell a Medicare Advantage plan for 2021 to seniors in eight counties in a new model that they say will lead to better health and lower costs.

Horizon Blue Cross Blue Shield of New Jersey and Hackensack Meridian Health said Monday they have formed a joint venture to operate Braven Health. And they are working with RWJBarnabas Health to join the venture, pending regulatory approval.

"Delivering an excellent health care experience while making health care more affordable requires continued innovation in the ways we collaborate and operate," Luisa Y. Charbonneau, Braven's chief executive officer, said.

The announcement comes a month before Medicare open enrollment begins, giving seniors age 65 and older a chance to review and select their health coverage for 2021. Enrollment begins Oct. 15 and lasts until Dec. 7.

Medicare Advantage plans are operated by private insurers. Unlike traditional Medicare plans that allow consumers to visit any provider, Medicare Advantage plans typically have tighter networks.

But many of the Advantage plans also have lower monthly premiums and other benefits such as dental care, eye care and gym memberships.

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New Jerseyans have historically been slow to embrace the privately operated plans, but they are beginning to make up ground. In 2016, just 16% of Medicare-eligible residents had Advantage plans. Three years later, it was up to 28%, according to Kaiser Family Foundation, a health care research group.

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Braven will be available to residents in Bergen, Essex, Hudson, Middlesex, Monmouth, Ocean, Passaic and Union. Details of the plan won't be available until Oct. 1. And Horizon will continue to offer its own Medicare Advantage plan.

The partnership between Horizon, Hackensack Meridian and, perhaps, RWJBarnabas appears to be unique for New Jersey.

The insurer and health providers, once in a tug-of-war, have been working more closely together in recent years to try to staunch growing health care costs that appeared to do little to improve patients' health.

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In 2016, Horizon launched Omnia, an insurance plan that provided customers lower costs, as long as they visited Hackensack Meridian, RWJBarnabas and other hospitals in its top tier.

The companies, meanwhile, could share patient claims and clinical data, ideally helping them better manage their care.

Braven represents another step in the integration of insurers and providers. This time, Hackensack Meridian will have a role in operating the insurance plan as well, with RWJBarnabas hoping to join soon.

"We felt like the best thing to do was to partner with an insurer because we couldn't get the same outcomes on our own," Robert Garrett, Hackensack Meridian's chief executive officer, said. "We think we can do it better with these types of partners."

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Michael L. Diamond is a business reporter who has been writing about New Jersey's health care industry for a decade. He can be reached at [email protected].

This article originally appeared on Asbury Park Press: NJ health care giants team with Horizon to launch their own Medicare Advantage plan

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