Private Payers News

SCAN Group, CareOregon Plan to Combine, Form HealthRight Group

The new combined company that SCAN Group and CareOregon form would continue to serve Medicare and Medicaid beneficiaries.

SCAN Group, CareOregon, mergers and acquisitions, Medicare, Medicaid

Source: Getty Images

By Kelsey Waddill

- SCAN Group and CareOregon have announced that they will combine under the name HealthRight Group (HealthRight).

“For far too long, America’s not-for-profit managed care organizations have operated at a scale disadvantage to their larger for-profit competitors. HealthRight aims to bring together two complementary organizations to benefit from greater scale, while maintaining focus on the people and communities they serve,” Sachin Jain, MD, chief executive officer of SCAN Group and future chief executive officer of HealthRight, said of the emerging payer in the press release.

The payers expected the transaction to close in 2023. Once closed, the combined companies will form a nonprofit healthcare organization that serves Medicare and Medicaid beneficiaries. The payers’ leaders promised that members would experience no disruptions in their quality of care.

“What makes this process so unique is that it is additive. We are coming together as community-based healthcare organizations that are driven by local community needs, and we’re building on that,” said Eric C. Hunter, president and chief executive officer of CareOregon and future president of HealthRight’s Medicaid Division.

SCAN Group will become HealthRight Group, but the consumer-facing CareOregon and SCAN Health Plan brands will retain their names, boards, community connections, and staff.

The payers projected that HealthRight’s revenues will be $6.8 billion and the combined company’s enrollment would amount to almost 800,000 enrollees.

HealthRight’s assets will include a home-based primary care medical group for seniors, an in-home primary and palliative care provider, a medical group designed to care for homeless individuals, a Program of All-inclusive Care for the Elderly entity, and a medical group that serves Medicare beneficiaries offering chronic disease management and palliative care services.

One new element that the combined company will introduce is a new foundation for CareOregon. The foundation will fund local health improvements in Oregon

“CareOregon and SCAN are coming together to solve the most complex challenges in our healthcare system and compete effectively as not-for-profits in a marketplace all too often dominated by companies valuing profit over mission,” added Linda Rosenstock, MD, board chair at SCAN Group and future chair of the HealthRight board.

Prior to this announcement, SCAN Health Plan leaders shared their insights regarding building health plans tailored for the LGBTQ+ community, based on the payer’s experience designing their Affirm Medicare Advantage plan.

In addition to starting its LGBTQ+ health plan, SCAN Health Plan announced that it would expand its fully integrated dual eligible special need plan (FIDE-SNP) in California. At the time, the payer’s leaders announced that SCAN Health Plan continued to be the only health plan in California offering FIDE-SNPs.

Earlier in 2022, CareOregon announced a partnership with a behavioral health group to create an alternative payment model that promotes culturally specific provider services. The model would be rewarded for cultural competency and access to care in various languages.