Oscar, Cleveland Clinic join forces to offer individual health plans in Ohio

Oscar Health and Cleveland Clinic aim to offer consumers a “seamless, guided healthcare experience” with their new co-branded health plans. (Marc Buehler / CC BY-NC 2.0)

What happens when a tech-focused insurance startup and a world-renowned health system team up to sell health plans in a market beset by turmoil? Oscar Health and the Cleveland Clinic intend to find out.

The startup insurer and health system announced Thursday that they will offer co-branded individual market products both on- and off-exchange in Ohio starting next year, pending regulatory approval.

Ohio has been in the spotlight lately amid the debate over the Affordable Care Act, as Anthem’s decision to exit the state’s marketplace next year left 18 counties facing the possibility of having no exchange insurer, according to the Ohio Department of Insurance.

However, none of the five counties where Oscar and the Cleveland Clinic will offer individual plans are the ones projected to have no exchange options next year. The organizations chose those specific counties simply because they are the areas where Cleveland Clinic facilities are located, Oscar spokeswoman Emma Riccardi wrote in an email to FierceHealthcare.

The new health plans aim to offer consumers a “seamless, guided healthcare experience” that will leverage both organizations’ best attributes.

For example, each member will be assigned to both a Cleveland Clinic Care Team made up of a dedicated primary care doctor and care managers, and an Oscar Health Concierge Team composed of a nurse and three care guides. The idea is for the teams to work together to proactively meet members’ health and wellness needs.

Keeping with Oscar’s own heavy focus on technology to improve the member experience, members will be able to access telehealth services through Cleveland Clinic's Express Care Online and Oscar's Virtual Visits with no co-pay. In a blog post about the new partnership, Oscar CEO Mario Schlosser adds that members will have access to optimized care search tools and a “beautifully designed mobile experience.”

“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 healthcare costs down,” Schlosser said in the companies’ announcement.

Thursday’s announcement is the second time this week that Oscar made headlines, as it also launched a new machine learning tool that seeks to deliver relevant clinical insights to physicians.

Despite all the new ventures it is undertaking, Oscar is not yet profitable. In fact, the startup lost $204.9 million last year. Things may be looking up, however, as Oscar lost just $25.8 million in the first quarter of 2017—nearly half of the amount it had lost by the same time in 2016.