Dive Brief:
- UnitedHealth has said it may exit the public exchanges in 2017, yet it has created Harken Health to make health insurance simple and easy to understand, according to a recent report from 4site Health.
- Harken is based on the idea that coordinated primary care with engaged clients will mean fewer hospitalizations, better chronic disease management, and better disease prevention.
- Dave Johnson, CEO and founder of 4sight Health, wrote in his blog United's partnering with Iora Health "speaks to United’s willingness to explore and potentially embrace disruptive delivery models.”
Dive Insight:
Harken Health's membership benefits include 24/7 access to Harken Health doctors, access to UnitedHealth's network of 850,000 physicians and hospitals, and complimentary wellness classes including cooking, nutrition, and yoga.
"United is losing hundreds of millions on the public exchanges," Dave Chase wrote in Forbes. "Meanwhile, virtually no one has noticed perhaps the smartest move I’ve seen any health insurer make—build a de novo value-based primary care model from the ground up that is optimized for the consumer and small business market that the exchanges target."
Chase predicts, "If successful, Harken positions United to succeed in a consumer-oriented post-reform healthcare environment where service provision aligns with customer needs."
This approach may prove to be timely, especially in light of a recent HHS panel’s ruling that decided a private Medicare plan must cover sex-reassignment surgery for a transgender woman – the first such decision of its kind. A U.S. Air Force veteran, Charlene Lauderdale, was denied surgery through a UnitedHealthcare/AARP Medicare Complete plan in 2014. Last April, an administrative judge with HHS ruled the plan must cover the surgery and the agency’s Medicare Appeals Council upheld that decision last month.
Lauderdale’s lawyer Ezra Young told The New York Times although the decision is not legally binding on other cases, it could be an important “guidepost.” HHS is also considering a proposed regulation to prevent private insurers from discriminating against transgender patients.
Harken Health would not reveal any expansion plans to other cities, but Vanderheyden told Forbes, “Harken Health was created with the mindset that access to quality, relationship-based primary care should be available to everyone." That's good news for the estimated 700,000 transgender Americans and for those who have the 100 to 500 sex reassignment surgeries done every year in the U.S.