Horizon Blue Cross Blue Shield of New Jersey, Hackensack Meridian Health and RWJBarnabas Health announced Monday the creation of Braven Health, a company built on providing better access and flexibility to Medicare Advantage consumers.
ROI-NJ caught up with the leaders of the three organizations and Braven Health to get more insights into how it was created — and how they feel it will benefit seniors in the state.
Here’s a look at the conversation:
ROI-NJ: This announcement seemed to come out of the blue, but, obviously, it’s been brewing for some time. Talk about the origin and the process?
Bob Garrett, CEO, HMH: It’s actually been almost four years in the making. We were thinking about new and innovative ways of how to care for the senior population of New Jersey, and we felt the best way to do that was to take the expertise of our health system and pair it with a health insurer. We interviewed a number of different health insurance partners, and Horizon Blue Cross Blue Shield rose to the top pretty quickly. They were New Jersey-based and shared a lot of our values about providing quality care at lower costs to really provide maximum value to the patients that we serve.
And then we started having conversations with RWJBarnabas Health because we felt that, by establishing a company, Braven Health, and expanding this offering to other health care systems in New Jersey, it would only strengthen our offerings. And, of course, we have a lot of respect for what RWJBarnabas has done to improve quality health care to be on the forefront of value-based care in the state of New Jersey. So, they became a natural partner to this endeavor.
ROI: That leads to a natural follow-up: Should we expect other health systems to join?
Gary St. Hilaire, CEO, Horizon: Definitely. From our perspective, this isn’t a network play, this still involves our broader network. There’s an opportunity for us to work collaboratively with all our provider partners in this initiative, and, certainly, we’re open with our partners here to just speak to whomever, where there’s opportunity. We don’t view this as a kind of limited exercise, but really an opportunity to advance innovation.
ROI: Depending on your view, New Jersey is either the biggest small state or the smallest big state in the country. This much is certain: An organization such as this is able to work the entire state. Is that an advantage?
John Doll, chief financial officer, RWJBH: Certainly. The fact that we are all New Jersey organizations that know the state well gives us an edge to make this successful. The model’s been tested in other parts of the country with success. We’re going to build on that success.
ROI: You mention other states — was there one particular model that you looked at, or is this a combination of a lot of models?
Patrick Young, president of population health, HMH: We went around the country to see how other organizations have facilitated a provider-payer relationship. And we thought the best way to really optimize the strength of organizations such as Horizon — their reputation, claims adjudication, member satisfaction, governance — was to team it with the clinical activities around Hackensack Meridian Health. As a provider, we thought it was the best model to really accelerate this and to meet the needs of senior citizens across the state.
ROI: Health care in New Jersey has been filled with unique partnerships and affiliations — not to mention numerous mergers — in recent years. And each had to be vetted for antitrust issues. Is there any concern with that here?
BG: This already has gotten review and scrutiny from the Department of Banking & Insurance. I don’t see any roadblocks or any barriers when it comes to the regulatory environment. I think this is something that the regulators looked upon very favorably, this type of collaboration and the types of goals that we’ve set out for Braven Health.
GSH: I think we’re adding another competitor, if you will, in the marketplace — and giving our members more choice for the kind of products they’re looking for. So, this becomes another choice. And, anytime you add choice to the equation, I think everybody wins.
Allen Karp, executive vice president of health care management and transformation, Horizon: CMS is the governing body of the Medicare Advantage program. We had discussions with them in a lot of detail about what this partnership was. They’ve seen this in other markets, so this is not unusual. We’ve run this through CMS, and they were OK with it.
ROI: Let’s turn to how it will work, so we turn to Luisa Charbonneau, the CEO of Braven Health. You are not from New Jersey — and this is a unique environment to walk into. Talk about overseeing so many big organizations, and the challenges and opportunities that come with that?
Luisa Charbonneau: I’m thrilled to be able to come in and work with these big players, because they are the folks that really know New Jersey and they have a long history and legacy of caring for New Jersey. Anytime you bring a lot of folks together to the table, it can be challenging, but I’ll tell you, in the short time that I’ve had the privilege of working together with this group, it is very collaborative engagement, and I’m really excited for what Braven Health can bring to seniors.
ROI: Let’s talk more structure. Will there be a board?
AK: There is a board structure. Luisa is the CEO, but there will be a Braven Health board and there will be a holding company. The board is made up of equal representation, so everybody will have a seat at the table.
ROI: Including the doctors: They won’t be on the board, but they will have input. For that, we turn to Dr. James Clarke, vice president, primary care and care transition, at Hackensack Meridian Health. Talk about how doctors will be involved?
James Clarke: The opportunity for the physician to partner with the largest insurance company in New Jersey and two of the biggest hospital systems is big. We will be on a provider advisory board, having some say on what’s going to improve the care of our patients, what’s going to make it easier for access, what are the things that we think are important for the care of our community. There is a plan to go out to all the clinicians every few months to ask them what they also think they need to provide Medicare in New Jersey. Having a voice at the table is very important.
ROI: We’ll give the final word to Bob Garrett.
BG: I think one of the main reasons this is going to work — and we shouldn’t underestimate it — is our shared values. Whenever you bring a partnership together, that’s an important element. I think our three organizations share some of the same core beliefs and value-driven philosophies about improving health care. So, you might not be able to see that on a national scale, but, because we are all working relatively in the same market and share some of those same values, we’ll be very successful.