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Brightside Health plans to enter into new and expanded payer partnerships to support telehealth access through Medicare and Medicaid, with companies including Blue Shield of California, CareOregon, and Centene.
The news comes after the company, which serves people with mild to severe clinical depression, anxiety and other mood disorders, announced it would begin serving 50 million Medicaid and Medicare beneficiaries. It was announced just a few months later.
These people will have access to all of Brightside Health’s mental health services. It includes psychiatry, therapy, and crisis care programs for people at high risk of suicide, and has shown positive results in its first year.
what is the impact
The partnership includes a new contract with CareOregon, which provides Medicaid. New contract with Blue Shield of California to serve Medicare Advantage. Expanding contract with Blue Cross and Blue Shield of Texas to include Medicare Advantage. Expands traditional Medicare contracts to include Texas, California, Delaware, Arizona, New York, Washington, Florida, North Carolina, Michigan, and Illinois. and a state-by-state expansion agreement with Centene that includes Nebraska Total Care Medicaid and WellCare Medicare Advantage.
A recent study in Psychiatry Research showed that the prevalence of suicidal ideation and attempts among Medicaid recipients was statistically significantly higher than among privately insured individuals.
The Centers for Medicare and Medicaid Services reports that of the 65 million Americans enrolled in Medicare, 25% experience mental illness, and Brightside believes that quality He pointed out that this suggests the need to provide high quality mental health care.
In October, Brightside announced that it would partner with Optum and other health care providers to provide telehealth-based mental health care to Medicare and Medicaid beneficiaries, giving the company access to in-network mental health services for an additional 50 million people. It was announced that the total number of users will reach 50 million people. Covered over 100 million lives.
bigger trends
Last year, Bright Health announced that it would sell its California Medicare Advantage business to Molina Healthcare and use the proceeds to strengthen Bright Health’s capital position and meet its obligations to bank lenders. The remaining funds will be used to pay for the insurance program’s debt under the repealed Affordable Care Act. The company also announced that it has extended forgiveness and modifications to its credit facility.
Molina amended the purchase agreement in December. The purchase price for this transaction has been reduced from the previously announced $510 million to approximately $425 million, excluding certain tax benefits, and represents 23% of expected 2023 premium revenue of $1.8 billion. equivalent.
Bright Health is not alone in facing financial challenges. Other insurance tech companies, including Oscar Health and Clover Health, were trading at much lower prices than when they went public, according to a June article in the Wall Street Journal. This is despite the fact that AI is expected to transform the insurance business.
Oscar Health stock has been on the rise since October 2023, according to Seeking Alpha. Clover Health’s stock price peaked in August 2023. Managed care stocks have been hurt by the surge in medical usage.
The business of health insurance and the way people pay for it haven’t fundamentally changed, making it difficult for startups to grow at scale, the Journal said.
Jeff Lagasse I am the editor of Healthcare Finance News.
Email: jlagasse@himss.org
Healthcare Finance News is a publication of HIMSS Media.