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Thursday, 30 July 2026 |
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| Included Health’s deal to acquire Firefly Health is a big bet on the future of alternative health plans. |
| Alternative plans aren't your traditional broad-network PPO, narrower HMO or high deductible design from big names like UnitedHealthcare and the Blues. They pull some novel levers, like lowering copays when patients choose the best doctors. And they’ve been gaining traction, albeit slowly, as rising medical costs strangle employers and workers alike. |
| In January, Included introduced its own alternative plan design. It liked the early interest, and so it’s doubling down and buying Firefly. Firefly started out delivering virtual primary care in 2018 before launching an alternative health plan in 2024 that incentivizes patients to go to high-quality, low-cost healthcare providers. The companies
declined to disclose the financial terms of the deal. |
| Firefly CEO Fay Rotenberg told me the deal “has been both months and years in the making.” |
| Both companies, she said, focused first on the care network and helping patients navigate through the health system, while other companies in the space put plan design first. That shared orientation is key to “really consistently and sustainably control total cost of care without sacrificing member experience or clinical quality outcomes.” (Rotenberg said Firefly has seen a 15%+ reduction in total cost of care across the employers it works with.) |
| It’s also a point of differentiation in what’s becoming a competitive market. New entrants such as XO Health are launching plans to compete with players like Centivo and Surest. And almost a third of large employers either offer or plan to offer at least one non-traditional medical plan in 2027, according to a
June survey by benefits consulting firm Mercer. Another 38% are thinking about it. |
| Rotenberg said it used to be that Firefly would compete in employers’ requests for proposals that would include all types of health plans, including the big, traditional ones. But this January, the company saw a tenfold increase in requests specifically aimed at alternative health plans. |
| It’s tough to know just how much growth the alternative health plan segment is seeing. Firefly declined to share stats on the company's size. A glance at giant insurers' financial reports tells me UnitedHealthcare, Aetna and Cigna aren't losing employer business. But if employers finally get fed up enough with costs rising 9% a year, they may start to make moves. |
| “I think everyone is ready to make a change,” Rotenberg said. “It is a combination of trend being unsustainable, but also enough proof points and data points that this really works. So it feels less risky.” |
| - Shelby |
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RIP Clipboard |
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During a one-year anniversary event for the CMS’ Health Tech Ecosystem initiative on Monday, agency officials staged a mock funeral — complete with a coffin that read "RIP Clipboard" — in a skit about the agency's push to move the healthcare industry away from outdated analog workflows. |
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This week in health Тech |
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Membership in Centene’s ICHRA plans (individual coverage health reimbursement arrangements) climbed to 50,000 people, the insurer revealed during its second quarter earnings call on Tuesday. That’s up 2.5 times over last year’s membership. “Great growth rate, small numbers. But I would say that there is no shortage or abatement in the interest and energy around ICHRA as an alternative,” CEO Sarah London said. Centene’s revenue grew 9.9% to $53.6 billion in the quarter, while net income was $1.1
billion, up from a loss of $259 million last year. |
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Worldwide made. Thanks for reading.
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