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Bright Health Exits Individual, Family Plan Markets

Analysis  |  By Jay Asser  
   October 12, 2022

The health insurer will also no longer offer Medicare Advantage plans outside of California and Florida.

Bright Health Group is scaling back its business in 2023 by cutting individual and family plan offerings, as well as removing Medicare Advantage products outside of two states.

The payer announced its decision to remove Affordable Care Act plans while also saying it has raised $175 million that is expected to close in the coming weeks and "take the business through profitability."

Bright Health will turn its focus to its Fully Aligned Care Model, which the company states is "a faster path to profitability, has greater predictability, and is more capital efficient."

The shift allows the health insurer to reach profitability on an adjusted EBITDA basis in 2023, with $3 billion in net revenue expected next year, according to the health insurer. The $3 billion is down significantly from the $6.8 billion in revenue expected in 2022 from the company's second quarter earnings report, which also showed a net loss of nearly $432 million in the first half of the year.

"We have demonstrated the power of the Fully Aligned Care Model in serving aging and underserved populations and progressed the marketplace towards seeing the promise in value-based care across all populations," Mike Mikan, Bright Health Group president and CEO, said in a statement. "The changes announced today give Bright Health a strong and stable platform for profitable growth at much lower risk. This is one more strategic step to building a differentiated and profitable business at scale."

As of June 30, Bright Health had 970,000 commercial members, 120,00 Medicare Advantage members, and 500,000 NeueHealth patients.

With this recent announcement, along with previously announced market exits, Bright Health will not offer individual and family plans in Alabama, Arizona, Colorado, Florida, Georgia, Nebraska, North Carolina, Texas, and Tennessee after 2022. It will also not offer Medicare Advantage plans outside of California and Florida.

Bright Health said it will continue meeting the needs of members for the rest of the year and will work with impacted members in the move to new plans during the upcoming annual and open enrollment periods.

Jay Asser is the CEO editor for HealthLeaders. 


KEY TAKEAWAYS

Beginning in 2023, Bright Health will not offer individual and family plans, while distilling its Medicare Advantage offering down to two states.

As of June 30, the payer had 970,000 commercial members and 120,000 Medicare Advantage members.

The company said it expects to reach profitability on an adjusted EBITDA basis in 2023, with $3 billion in net revenue expected next year.


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