Horizon to form Medicare Advantage organization with HMH, RWJBH

N.J.’s 3 largest health care players say Braven Health will be able to offer more flexibility in more seamless fashion to Medicare-eligible members in 8 counties

Horizon Blue Cross Blue Shield of New Jersey and the state’s two largest health care networks — Hackensack Meridian Health and RWJBarnabas Health — are making a big push into Medicare Advantage with the creation of Braven Health, they announced Monday afternoon.

Braven Health will be owned and operated jointly by Horizon, the state’s largest health insurer, and Hackensack Meridian Health. The two are working to have RWJBarnabas Health join Braven Health, subject to approval by the New Jersey Department of Banking & Insurance.

Longtime health care executive Luisa Charbonneau will serve as CEO.

Braven Health plans use Horizon’s existing Medicare Advantage managed care networks, meaning that every doctor and hospital that participates in those networks also will be in-network for comparable Braven Health plans. In addition, as a Blue Cross Blue Shield plan, Braven Health members choosing a PPO plan also will have access to the BCBS national Medicare Advantage PPO network whenever outside of New Jersey.

Braven Health will be available in eight of the state’s 21 counties at the outset (Bergen, Essex, Hudson, Middlesex, Monmouth, Ocean, Passaic and Union) due mainly to the geographical reach of the facilities in the Hackensack Meridian and Barnabas systems. Horizon officials said the reach of the plan could grow in coming years.

The three organizations said the joint venture stems from years of work they have done together to advance value-based care through the OMNIA Health Alliance.

###

Charbonneau is a newcomer to New Jersey, but has an accomplished background as a senior executive, with more than two decades of leadership in both startup companies and complex health care organizations.

Luisa Charbonneau will lead Braven Health. (Peerfit)

Charbonneau served most recently as the senior vice president at Peerfit, a company dedicated to empowering seniors to live healthy and active lifestyles. Prior to that, she led the Medicare business as the vice president of government markets at Florida Blue.  She also has served as vice president for Medicare and government programs at Coventry Healthcare/Aetna in Florida and spent 10 years in a variety of leadership roles with Humana.

Charbonneau said Braven Health represents another step in the innovation and re-creation of health care.

“Delivering an excellent health care experience while making health care more affordable requires continued innovation in the ways we collaborate and operate,” she said. “As health care companies with impressive track records of working together to improve health care, these are the perfect partners to help Braven Health be accountable to the customer and bring true innovation to the Medicare market.”

Gary St. Hilaire. (File photo)

Horizon CEO Gary St. Hilaire said the goal is to provide Medicare-eligible New Jerseyans with a health care experience he calls comprehensive, integrated and simple to navigate.

“Braven Health is a new way to health for a new generation of Medicare members,” he said. “This partnership is the culmination of years of work together with partners that possess a shared dedication to health care innovation and patient-centered care. Through Braven Health, Horizon and its provider partners will share total responsibility for the cost and quality of the care that our members receive.”

The leaders of Braven Health feel it represents a major milestone in the state’s journey to transform the fee-for-service health care system and improve health care quality, affordability and the customer experience through greater integration, coordination and alignment.

###

As New Jersey’s first payor-provider-owned health plan, Braven expects to leverage the collective brand strength of each organization to deliver high-quality, personalized care at a lower cost.

Here’s how it will work: Braven Health will have a practitioner council made up of physicians representing various specialties. This council will provide recommendations to the Braven Health CEO and board of directors on ways to improve the plan from the practitioner’s perspective, giving them an active role in Braven Health and helping ensure a better experience for the provider community.

Bob Garrett, left, and Barry Ostrowsky. (File photos)

The concept is not new. Horizon and the hospitals are following a growing trend in the Medicare space, which gives seniors more flexibility as the insurers are able to offer coverages for some things traditional Medicare does not cover. Because of that, there can be some increased costs.

Hackensack Meridian Health CEO Bob Garrett and RWJ Barnabas Health CEO Barry Ostrowsky feel the program will bring increased access and flexibility — done in a more seamless fashion.

Garrett said finding innovative ways to deliver care is at the core of everything Hackensack Meridian does.

“Embarking on this partnership with Horizon was a natural progression in our quest to make health care seamless and less stressful,” he said. “We are a national leader in delivering high-quality, affordable health care to our Medicare patients through our Medicare Accountable Care Organizations, and Braven Health provides our Medicare patients with a new option for care.

“Additionally, this unique company creates a stronger partnership with our physicians and practitioners.”

Ostrowsky said the partnership is all about increasing access.

“We are proud to stand with two organizations who share our vision for enhancing the health and wellness of our state — namely, Hackensack Meridian Health and Horizon — and I am confident Braven Health will yield amazing benefits for New Jersey’s Medicare population,” he said.