We are strong supporters of Oscar’s commitment to fixing health care. It’s core to who we are, too. Enabling a better experience for all and connecting health care is why we exist. Let’s embrace our relentless passion and define the future of health care – together.
I am looking forward to getting to know the Oscar team and digging in to find opportunities for us to grow together and work toward improved health care for all. With the recent formation of our health services business, Evernorth, we are better positioned than ever to support you and your clients to create a better experience for your team, members and providers.
MEDICARE MARKET INSIGHTS
We operate on a belief that insights can lead to better action, and our Medicare strategists will equip you with market analyses for growth planning and insight-driven conversations focused on enrollment trends, Star Ratings trends, competitive market benefits and other aspects of plans in your current service areas, or any county you may consider for expansion.
HEALTH INSURANCE EXCHANGE
While CMS' cancellation of the QRS Enrollee Survey last spring due to the pandemic was disappointing, we're anxiously awaiting the QHP 2022 open enrollment star ratings along with you! The silver lining is that it has given us all more time to plan for a brighter Public Exchange future. We are here to help strategize with Oscar to best position you for growth.
OSCAR HEALTH AND EXPRESS SCRIPTS: NATIONAL EXCHANGE FOOTPRINT
Having a presence across the Midwest and beyond, we bring the critical expertise you need as you continue to thrive. We know your present and future markets and look forward to helping you grow.
INTRODUCING EVERNORTH
Meet Evernorth, which brings together game-changing capabilities in life-changing ways – including benefits management, pharmacy and medical solutions, tailored to our customers’ specific needs, innovative clinical and behavioral care, pharmacy solutions from daily prescriptions to specialized therapies, and data, analytics and insights to derive value and solutions for your organization.
HEAR FROM OUR CLIENTS
See how we helped a client grow their Medicare business. We offer the guidance and support necessary to help our clients improve quality outcomes and Star ratings.
Medicare market analysis: Key insights and findings
We operate on a belief that insights can lead to better action, and our Medicare strategists will equip you with market analyses for growth planning and insight-driven conversations focused on enrollment trends, Star ratings trends, competitive market benefits and other aspects. These analyses can be done at the state level, service area level, or county level to meet your needs. An initial look generated some insights for conversation.
Industry-leading MAPD member retention is key to managing plan cost and educating members on adherence programs.
Express Scripts leads the PBM industry with an MAPD average of 4.9 Stars on retaining members, while the industry average is 4.4 Stars for members choosing to leave the plan.
Industry-leading Medicare Plan Finder scores demonstrate how we show up for members as they shop and purchase at the pharmacy counter.
Express Scripts leads the industry with an MAPD book of business average of 5.0 Stars vs. the industry MAPD average of 4.0.
Are you getting the strategic support your need to target multiple price points across market segments?
Oscar's HMO plan growth in your markets is phenomenal. However, your PPO market is growing and three times the rate of the HMO market.
YOUR TRUSTED PARTNER IN REGULATED MARKETS
We're squarely focused on the quality metrics that are important to you and know that out support will help you move the needle on becoming market-leading – today and in the future. Through our clinical programs, network strategy, formulary management and levers designed specifically for regulated markets, we want to be your partner of choice.
ENABLING PROGRESS THROUGH DATA AND TECHNOLOGY
We're committed to making pharmacy better to improve health outcomes. Learn more about our first-class mobile app.
Enabling progress through data and technology
We provide on-demand reporting with data you need to effectively manage your pharmacy benefit program. 80+ templates can be run on-demand or scheduled to run on a periodic basis, leveraging more than 250 data elements available.
Enabling progress through data and technology
Our data-driven tools and technologies help remove barriers to care and offer a simpler, better experience for physicians and their staff and patients.
Enabling progress through data and technology
Our data-driven tools and technologies help remove barriers to care and offer a simpler, better experience for physicians and their staff and patients.
API AND SECURITY
Our API can help you deliver solutions for members, patients and prescribers. Your developers can utilize the API documentation and specifications to aid them in your efforts.
LOWER COSTS + IMPROVED OUTCOMES = BETTER RESULTS, GUARANTEED
Health Connect 360 is an outcomes-based approach that delivers personalized clinical support to yourmembers and connects you, your medical carrier and other clinical partners together to ensure each person gets the clinical case support they need, and nothing they don’t – guaranteed.
INNOVATING FOR THE FUTURE OF HEALTH CARE
As quickly as the health care landscape evolves, we're constantly innovating in turn, to help our clients stay ahead and achieve better clinical and financial outcomes. We're committed to unlocking new value through innovation that benefits your plan, your clients and health care as a whole.
THE RESULTS ARE IN
The previous year amplified health care challenges that first emerged during the early days of the pandemic – while simultaneously giving rise to new patterns Analyzing these trends enables us to anticipate challenges, drive action and create change. In Q4 2021, Evernorth partnered with Ipsos to conduct a U.S. survey of more than 3,000 consumers with employer-sponsored health insurance, as well as 575 human resources decision-makers (HRDMs) and 58 health plan leaders (HPLs). Our analysis of the data revealed three key insights.
DEMANDS FOR HYBRID HEALTH CARE
Over the last decade, virtual health solutions have gone from fledging to full tilt – with the onset of the pandemic normalizing virtual and digital health as mainstream options for care. In fact, telehealth visits increased from 0.3% in October 2019 to 29.6% in April 2021. After the acceleration of virtual care throughout the pandemic, there are notable differences in the ways consumers are using it – and what they hope to get out of it. In many circumstances, consumers actively opt for in-person care, suggesting the need for a hybrid model that combines virtual and in-person care.
UNIVERSAL EMPHASIS ON MEETING BEHAVIORAL HEALTH NEEDS
As the importance of behavioral health is increasingly recognized, few dispute its strong connection to overall health, both in the medical community and the general public. It remains top of mind as a top concern. Dissonance only arises when it comes to defining and prioritizing behavioral health needs. Plan sponsors invest in solutions that individualize behavioral health success but consumers rank contextual, broader benefits, such as work life balance as much more important.
CALL TO COLLABORATE ON ACCESS AND AFFORDABILITY
As concerns about health and well-being become the new standard, COVID-19 will likely have a powerful effect on members plan sponsors for years to come. In this context, members are anxious and disgruntled, expressing deep concerns about both cost and quality of health care. And while care remains more of a priority than ever, employees’ fundamental lack of trust has grown so entrenched, it has driven a shift in the market.
Never miss an update
View our latest insights below and sign up to receive our latest news.
Explore the Regulated Times newsletter
Our Regulated Times newsletter is curated bi-monthly and highlights updates relative to state and federal regulations, legislation and rulings.
Evernorth newsletter
Subscribe to our updates to receive the Evernorth newsletter.