Oscar and Humana set sights on small business insurance market
- Oscar Health and Human are teaming up to offer commercial health insurance to small businesses in central Tennessee, beginning this fall.
- The partnership will initially focus on commercial plans for businesses of 50 or fewer employees in nine counties in and around Nashville.
- The collaboration joins Humana’s experience in coordinated care, health and wellness with Oscar’s data-driven approach to member engagement, the companies said Wednesday.
The partnership comes as both Oscar and Humana are looking for new business avenues outside the Affordable Care Act (ACA) exchanges, which are struggling with instability amid political uncertainties.
And there are plenty of opportunities to pursue. The individual health insurance market, which includes the ACA exchanges, affects just 7% of the population, or about 21.8 million people, according to Axios.com. By contrast, the employer-based market affects 156 million people.
According to the Small Business Administration, there are 28 million small businesses in America, comprising 54% of all U.S. sales. So the opportunity is clear.
Oscar has already made several moves this year to expand its focus from the exchanges to individual health insurance. In February, the New York-based firm began selling plans in the small group insurance market. It has also partnered with Mount Sinai Health System on a full-service primary care center in Brooklyn.
Then last month, the tech firm and Cleveland Clinic announced plans to offer co-branded health plans to people living in northeastern Ohio. Oscar also recently waded into the doctor’s office with a virtual clinical dashboard aimed at enhancing profiles and using data to tease out clinical insights.
Humana, too, has been making adjustments in the wake of its failed megamerger with Aetna. In March, the Louisville-based payer announced it was eliminating some jobs and creating new ones to align with the company’s growth plans. The company scaled back its ACA participation significantly in 2016 and plans to exit the markets altogether in 2018.
In a article published on LinkedIn, Humana President and CEO Bruce Broussard the healthcare system needs to provide a better patient experience at more affordable costs. “We need an integrated system that is financially incentivized to reward for optimal health, not optimal utilization,” Broussard wrote. “Only by integrating the clinical, health and lifestyle components, with a personalized, high quality and efficient experience as the end product, can we help transform healthcare.”
The companies said they selected Nashville to launch the partnership because it is a hotbed for both small business and health IT innovation. The collaboration is subject to regulatory approvals.