4 min read April 2023 — Luisa Charbonneau, CEO of Braven Health, sat down with Invest: to discuss Medicare Advantage and how its popularity is evolving among New Jersey residents, as well as the next chapter of healthcare, including increased collaboration between players and upcoming or proposed legislation she is watching.
What highlights have existed for you in the past year?
Our top highlight has actually spanned over the past few years. We launched our health plan in January 2021 as a brand new plan with zero members and it’s become the fastest-growing Medicare Advantage Plan for individuals in the State of New Jersey for the third year in a row. Growth has been phenomenal; we have been incredibly fortunate and successful in this arena. We now have just over 41,000 members in our health plan. New Jersey has not seen that kind of growth from any carrier, particularly in this market, in the last 10 to 15 years.
How does that relate to the state of the healthcare industry in New Jersey as a whole?
There are a few factors at play. Part of it is the state of the economy that may be driving people more toward Medicare Advantage plans, but also the popularity of Medicare Advantage growth in the U.S. in general. New Jersey was significantly lagging behind the national adoption of Medicare Advantage plans, but it has picked up over the last few years. However, it hasn’t quite reached the same level as the national landscape. Nationally about 48% of people eligible for Medicare choose a Medicare Advantage plan, and in New Jersey, it’s around 35% but it has more than quadrupled since 2008 and will likely catch up soon. People like the ability to have a more predictable cost share than a plan like Original Medicare, where individuals pay a percentage of the allowed amount for each service. Since most people don’t know the allowed amount before they receive care, it’s hard to predict how much they will be paying. Having a more steady and predictable cost has been important. Not only are our benefits and cost shares very competitive, but also what leads to Braven Health’s popularity is the notion that we are a combined entity. We were formed by a joint venture between the largest health insurance plan in the state, Horizon Blue Cross Blue Shield of New Jersey, and two of the largest health systems in northern New Jersey (Hackensack Meridian Health and RWJBarnabas Health). The combination of payer and provider working together is resonating, and that’s the way of the future in healthcare.
How are you bringing innovation to the Medicare market?
It’s the ability to better coordinate care, better share data and truly be able to look at both sides of the coin as partners. We are not competing; we’re working together for the benefit of the member, for the patient. There is a long way to go, and we are early in this stage of identifying the best, innovative ideas between the two, but I believe that is where the value will be long-term. Coming together in the delivery of care and paying for it will make a huge difference down the road.
There are some things that came out of COVID that caused this need for innovation. Through necessity comes innovation and the way care is delivered has changed. This will continue to expand, and it’s delivering care where people are and meeting people where their needs are, whether that’s virtual care or more healthcare at home.
What regulations or legislation are you monitoring?
Every year, the government issues a set of proposed rules and final legislation that affects Medicare Advantage. They generally address the payment rates to Medicare, changes in risk adjustment policies and activities and changes in quality measurements. We are looking at those very specifically for the year ahead. In addition to that, we have the Inflation Reduction Act, which has a number of health care provisions and will have an impact on Medicare Advantage over the next few years, predominantly in the prescription drug aspects of the plan. The Act provides access to recommended adult vaccines , like the shingles vaccine, without cost-sharing, it establishes a yearly cap on out-of-pocket prescription costs and makes Insulin available at a reduced cost of $35/month per covered prescription among other provisions aimed at reducing the cost of prescriptions.
It’s already important to us that members have access to insulin, and we were ahead of the curve and already participating in a program called the senior savings program for insulin that allowed us to reduce the insulin costs, but it’s now mandated and individuals will see this universally from all plans. It will take several years before the impacts of the act will be fully realized.
What are you focused on as it relates to accessibility and affordability?
Accessibility and affordability ultimately lead to more positive health outcomes, so we are always focused on that. Communication is key to help members choose the best plans for their circumstances and then to understand how to use all of their benefits. We want to promote overall health literacy, which supports individuals in things like getting preventive screenings that catch diseases early. Clear communication is also an important part of the member experience and we are focused on optimizing it by providing information in the ways today’s seniors want to receive it, whether that is in-person, through a call, on paper or digitally. Providing affordable benefits is very important but you also have to manage both informing and educating people on getting their important screenings and ensuring care is accessible to them. This is one of the most complicated industries in the world. There are so many stakeholders and moving pieces. It’s complicated for people who work in it every day, let alone those who don’t, especially for seniors where most of their insurance had previously been purchased through their employers. The task of comparing and understanding the differences in plans and choosing what to offer was primarily on the employer, and now the responsibility is on them as they retire. It can be confusing.
What are your priorities looking ahead?
My No. 1 priority is to serve the seniors and the Medicare-eligible population in the State of New Jersey in the best possible way we can. That encompasses many things; we want to continue to grow and be the plan that people choose in New Jersey because we have great benefits and services. We’re a good partner. We are someone who can be that trusted guide through health care because, as one of my colleagues likes to say, the No. 1 source of information is Dr. Google. We want to be trusted to cut through the clutter. You can get a lot of information on the internet; some of it is good, some of it is not accurate. We would rather they have a trusted support system. Secondarily, we will be working with our provider partners to simplify this crazy, complicated system to try to find ways to make navigating our health care infrastructure and ecosystem easier for people – get what you need when you need it in the place you need it most. Our goal is really to find the best ways to deliver that to members.
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