Medica launches private exchange to sell ACO products


Medica has launched its own private health insurance exchange, which it hopes will set itself apart from its competitors while simultaneously driving support for the accountable care organization model.

The second largest insurer in Minnesota has partnered with four ACOs, each of which will offer different products targeted for certain members through the exchange, reported AIS Health.

The My Plan exchange, which Medica is offering to its fully insured and self-funded employers, is an advanced private exchange that allows the ACOs to highlight their offerings to potential members. "We expect this to be a very important contributor to our success in the market," Simeon Schindelman, Medica's senior vice president of commercial markets, told AIS Health. "We like the position we're in."

Although the ACOs, which include Fairview Health Services, Ridgeview Medical Center, Park Nicollet Health Services and HealthEast Care System, operate within a similar contract, they "reflect the unique needs and values of each care system," Schindelman said. That means they each provide particular benefits designed to attract certain customers. For example, the HealthEast ACO focuses on wellness while the Ridgeview ACO emphasizes primary care.

Overall, the Medica ACOs must agree to reduce costs by dropping fees, improving quality and enhancing the member experience, Schindelman said. The Medica-Fairview ACO offers premiums that are 10 percent less than other Medica health plans, FierceHealthPayer previously reported. Medica also partners closely with the ACOs by, for example, sharing a call center with Fairview so members can get answers to insurance and medical questions in one phone call. The ACOs, in return, can share in any savings realized.

As the first ACO Medica partnered with, Fairview worked very closely with the insurer to design the health plan sold on the exchange and already has about 500 members from the private exchange. "We've actually held the cost curve flat or began to reduce it," while raising quality and member satisfaction, Mark Hansberry, Fairview's senior vice president of strategic and business development, told AIS Health. What's more, "there are no limitations of internal capabilities to continue to expand the product," he added.

To learn more:
- read the AIS Health article

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