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Cleveland Clinic Jumps Into Insurance Business

Move blurs line between payer and provider

The Cleveland Clinic and Oscar Health have made arrangements to offer co-branded health insurance plans to consumers in Ohio, marking the Clinic’s first entry into the health insurance market with a product bearing its name, according to an announcement posted on the PR Newswire website. Oscar Health was co-founded by Ivanka Trump’s brother-in-law, Joshua Kushner.

Beginning this fall, pending regulatory approvals, consumers in five northeast Ohio counties will be able to purchase Cleveland Clinic | Oscar individual health plans. These plans are expected to be sold on the Ohio health insurance exchange created by the Patient Protection and Affordable Care Act (PPACA) as well as off the exchange, with coverage beginning on January 1, 2018.

Members will be matched with both a Cleveland Clinic care team (consisting of a primary care provider, physician assistants, and other allied health professionals) and an Oscar Health concierge team (made up of a nurse and three care guides).

These teams will work together to ensure that each member’s health and wellness needs are proactively met, according to the announcement. Any time a member needs to seek care, they will have the option of a virtual visit through the Cleveland Clinic’s Express Care Online and Oscar’s Virtual Visits with no co-pay. Smartphone technology will help analyze their health needs; understand their care options and costs; and guide them to the right medical options.

The Cleveland Clinic will continue to work collaboratively with other health insurers.

Meanwhile, insurance providers across the country have exited the PPACA markets for 2018, citing uncertainty over whether the Trump administration will continue paying key insurer subsidies.

Last week, Anthem announced that it would quit the Ohio exchanges, leaving 18 counties with no provider in 2018.

Sources: PR Newswire; June 15, 2017; and The Hill; June 15, 2017.

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