Envision Changes Name to ELIXIR Insurance

[somarco]

The EnvisionRxOptions of today is part of the Rite Aid family of businesses, who also recently announced a brand and retail pharmacy refresh. As the only payer-agnostic, national PBM with a retail footprint, we have the ability to optimize the full pharmacy care experience. Having grown into far more than just a PBM, thousands of payers and millions of patients across the nation rely on us for their medication needs at a price everyone can better afford.

More Efficiency. More Service. More Value. Elixir is Coming.

Payer-agnostic?

Maybe @kgmom219 can enlighten us

 

[LostDollar]

Caveat, not an agent.

Payer-agnostic.

Sounds like an insurance agent that will sell both Medicare Supplements and Medicare Advantage Plans.

 

[ToddE]

"'Rite Aid is a business in the midst of a turnaround and it is time for a radical change - our RxEvolution,' said Heyward Donigan, president and chief executive officer, Rite Aid. 'This is not business as usual at Rite Aid. We have the unique opportunity to serve a growing customer base and strengthen the power of our iconic brand. We are doubling down on our pharmacy business.'"

...starting with doubling our monthly premium.

 

[vic120]

The EnvisionRxOptions of today is part of the Rite Aid family of businesses, who also recently announced a brand and retail pharmacy refresh. As the only payer-agnostic, national PBM with a retail footprint, we have the ability to optimize the full pharmacy care experience. Having grown into far more than just a PBM, thousands of payers and millions of patients across the nation rely on us for their medication needs at a price everyone can better afford.

More Efficiency. More Service. More Value. Elixir is Coming.

Payer-agnostic?

Maybe @kgmom219 can enlighten us

Seems like it is something to do with merging with pharmacies and or hospitals and or working direct to consumer maybe? not sure



We're working with about 13 health systems in different markets. Most of them we have not announced publicly. One is MedStar, here in the DC area, which is a $4 billion revenue health system. We're working with them to expand their managed care business, getting into Medicare Advantage. They were already in Medicaid. Of the other 10 that we're working with, I'd say probably six are considering, or actively considering, working on starting a health plan. The others are more in the mode of working directly with payers, but not starting their own health plans.

Regardless we view the competencies as very similar, which is being able to manage a population for better outcomes,

whether that contracting vehicle is your own health plan, or a contract directly with another payer,

it's very similar to us. Even the ones that are starting health plans are very clear that they want to continue to work with payers.

It's what we call a payer-agnostic approach,
meaning these capabilities could be used to start your own health plan, like Piedmont and WellStar are doing.

But it could also be used if the health system sets up a value-based contract, a capitated contract or a shared savings contract with an existing payer. So they might work in a given market with a Blue Cross plan, or an Aetna, a United or a Cigna, and those organizations, just as they have in California, delegate some of the functions and even the risk of managing the patient population into the provider system.

Q&A: Helping hospitals launch health plans

 

[somarco]

We're working with about 13 health systems in different markets. Most of them we have not announced publicly. One is MedStar, here in the DC area, which is a $4 billion revenue health system. We're working with them to expand their managed care business, getting into Medicare Advantage. They were already in Medicaid. Of the other 10 that we're working with, I'd say probably six are considering, or actively considering, working on starting a health plan.

I have known a few hospitals that wandered into the health insurance market and failed miserably. Recently (maybe 6 years ago) Piedmont set up an MAPD HMO plan in Atlanta. $0 premium (of course), $0 primary copay (as long as you used Piedmont hospitals).

I don't recall all the details but it had lower copay's and much lower MOOP than other plans in the area.

I thought they MIGHT make it 2 years. Seems like they limped into year three then died before the 4th year.

They had no idea how to price for risk and adverse selection.

Piedmont health system had (and still has) an excellent reputation for quality care.

But they suck at running a health insurance plan.