Oscar Partners with Montefiore for Medicare Advantage Plan

July 22, 2019 - New York-based Oscar Health will enter a joint venture with Montefiore Health System to provide Medicare Advantage plans to its members, the company recently announced.

Through the joint venture, the payer will offer Medicare Advantage plans to consumers in New York and Houston, Texas by 2020.

“We are looking forward to a long partnership with Montefiore that enables us to reach new members,” Mario Schlosser, CEO and co-founder of Oscar, said in the press release. “Oscar has built an experience that meets our members where they are, no matter their age or health history, and Montefiore, with its academic expertise, extensive physician network and longstanding success providing comprehensive care to Medicare beneficiaries has done the same. We are confident that our proven track record of providing health insurance with a superior member experience makes us an ideal match for Medicare Advantage’s consumer-driven model.”

The number of health plan issuers offering Medicare Advantage plans is projected to be highest in New York City, where Kaiser Family Foundation estimated 14 firms would be located in Kings and 14 in Queens in 2019. These figures are nearly matched by Los Angeles County and Miami-Dade County.

Oscar will be partnering with Montefiore along with other Bronx-based providers to provide members access to a network of eleven hospitals, with around 200 outpatient sites, Crain’s New York Business reported. Their network encompasses the Bronx, Westchester County, and the Hudson Valley region.

“Montefiore and Oscar are both innovators,” said Lynn Richmond, EVP and chief strategy officer for Montefiore Medicine. “Montefiore’s mission has always been to advance the health of our communities through innovation – providing care when and where people need it most. With Oscar’s technology-driven models and our aligned dedication to providing an exceptional experience for Medicare beneficiaries, we are creating a new approach that will promote health and well-being and provide a seamless, patient-centered experience.”

Oscar Health emphasizes offering technological solutions to members across health plans and their Medicare Advantage plan is no different. The Oscar Health Medicare Advantage plan will incorporate a mobile app, a concierge team with a nurse and service representatives, and telemedicine care available 24/7 for free. In the press release announcing the Medicare Advantage plan, the company claims that their technologies cut costs, with members who use Doctor on Call, their telemedicine service, saving an average of $129 with each call.

The Medicare Advantage plan will also give members access dental, vision, and hearing benefits, as well as over the counter credit and wellness rewards. The plan will also feature personalized care as well as online prescription and home delivery.

The Medicare Advantage plan got its start when Google’s parent organization, Alphabet, invested $375 million in Oscar Health in August 2018. The payer also previously raised $165 million from two other Alphabet companies.

The payer had always planned to venture into the Medicare Advantage space.

“Oscar will accelerate the pursuit of its mission: to make our health care system work for consumers. We will continue to build a member experience that lowers costs and improves care, and to bring Oscar to more people—deepening our expansion into the individual and small business markets while entering a new business segment, Medicare Advantage, in 2020,” Schlosser said at the time.

Alphabet’s investment in Oscar represents just one example of the trend toward venture capital investment in Medicare Advantage plans.

The trend toward private Medicare plans has been especially evident in New York, which saw a 78.3 percent increase in Medicare Advantage plans from 2008 to 2018, Crain’s New York Business noted.

Oscar plans to align enrollment in its new Medicare Advantage plan with this year’s annual election period for Medicare Advantage, which lasts from October 15 to December 7. However, the plan will be subject to CMS approval prior to those dates.

Oscar declined to discuss plan details beyond those outlined in their press release prior to CMS’s approval.