MMIT Payer Portrait: Bright Health

Founded as a consumer-oriented, technology-focused startup in 2015, Bright Health has quickly made its presence known in the health care industry, despite its newcomer status. The company launched its first product offerings in Colorado’s individual market in 2016 and has since expanded to offering individual, Medicare Advantage (MA) and small group plans in 17 states. Bright Health’s value-based care model revolves around partnerships with select health and hospital networks, including Tenet Health, Novant Health and HCA Healthcare, emphasizing the importance of the patient-provider relationship. CVS Caremark serves as Bright Health’s pharmacy benefits manager.

Bright Heath Group also operates a primary care and technology services subsidiary, NeueHealth. NeueHealth currently owns more than 130 primary care clinics nationwide, emphasizing value-based care in its network designs and cost transparency for payers and providers. In a Dec. 7 news release, Bright Health said it expects $2 billion in revenue from NeueHealth in 2022 and to grow its number of value-based patients to more than 400,000. Also in December, Bright Health received $750 million in funding from Cigna Ventures, Cigna Corp.’s investment arm, and co-investor New Enterprise Associates, fueled by NeueHealth’s promising outlook. “We look forward to exploring new ways that NeueHealth and Evernorth can potentially provide services to each other’s customers and clients,” Tom Richards, Cigna’s global lead of strategy and business development, said in a statement.

Bright Health went public in July 2021, raising $924.3 million during its initial public offering (IPO), a more successful launch than those of Oscar Health, Clover Health and Alignment Healthcare, the three other insurance startups that went public last year. But despite a promising start, the company has faced similar struggles to its peers, posting a $296 million net loss for the third quarter of 2021, plus an eye-popping 103% medical loss ratio. “Up until this quarter, Bright had actually performed not terribly,” Ari Gottlieb, a principal at the consulting firm A2 Strategy Group, told AIS’s Health Plan Weekly in November 2021. “The bulk of Bright’s business is still individual, and they’re following the same strategy as Oscar without the inflated tech and admin spending. They’re a follower of Oscar, and they’ve followed them down to the depths of stock prices.”

Still, the company is focused on expanding its exchange presence. Bright Health will enter 42 new markets for the 2022 plan year, becoming the first new insurer to enter the California exchange market in six years. The insurer’s plans will also be newly available on the Georgia, Texas, Utah and Virginia exchanges in 2022. Market expansion is not its only growth strategy, however. While the company’s 2021 enrollment surge was partially fueled by the COVID-19 pandemic’s impact on exchange sign-ups, Bright Health also completed multiple acquisitions throughout 2020 and 2021, key among them California MA org Brand New Day, Central Health Plan of California, Inc. and True Health New Mexico.

SOURCE: AIS’s Directory of Health Plans as of December 2021; MMIT Analytics as of 4Q 2021.

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