CareNu is starting to sign members up for health insurance through its Medicare Advantage plan for the first time.
The plan, offered through CareNu subsidiary SECUR Health Plan, is an Institutional Special Needs Plan, or I-SNP. It targets the highest acuity patients that account for the bulk of a health plan’s costs.
“We created this model for advanced chronic illness that is collaborative and very integrated,” said Paola Bianchi Delp, president and founder of CareNu and CEO of SECUR Health Plan, in an interview with Fierce Healthcare.
That interdisciplinary team—including social workers, case managers, pharmacy input and a primary care provider—is mixed with predictive analytics to help patients on a case-by-case basis. The model has been tested in CareNu’s ACO plan.
CareNu is an affiliate of Chapters Health System, one of the country’s largest nonprofit hospice organizations. In 2021, the company filed to establish a direct contracting entity called Assurity DCE under the predecessor program to the ACO REACH Model.
Over two years, Assurity DCE reduced emergency room visits and hospitalization for more than 5,000 people. Assurity DCE will continue to offer care for Medicare beneficiaries having already generated the Centers for Medicare & Medicaid Services (CMS) 43% savings.
Some payers are fleeing Medicare Advantage, either from limiting plan options and benefits or leaving markets altogether.
One exception in Medicare Advantage are SNPs. More than 6.6 million beneficiaries are in SNPs, twice the enrollment as 2019, KFF analysis of CMS data shows.
That trend is expected to continue going into 2025, though I-SNP plans will contract next year. There will be 162 I-SNP plans, with UnitedHealthcare and Humana the insurers with the highest number of these plans, analysis from ATI Advisory shows.
“Those are primarily the patients that most health plans struggle with,” said Delp. “From our perspective, we felt that’s our sweet spot. We understand advanced chronic illness. That’s not something we shy away from; it’s something we lean into and we do it well.”
SECUR Health Plan is licensed in five counties in Florida. Just one competitor, Simply Healthcare, operates in all five counties. Most of CareNu’s patients have five to seven chronic illnesses at one time, said Delp.
SECUR Advantage is geared toward members in nursing facilities and inpatient psychiatric facilities, while SECUR Enhanced offers similar benefits for those needing institutional-level care at home or in a facility, a news release explained.
“We thought it was a natural progression for us,” she explained. “It really gives us diversification opportunities for those that may need additional Part D benefits. They may need transportation [or other supplemental benefits.]”