When insurtech Brilliant Well being Group first emerged again in 2015, it had daring objectives of disrupting the insurance coverage business by leveraging expertise. It raised a whopping $2.4 billion — together with from Cigna Ventures — and went public in 2021 earlier than the IPO market dried up.
As soon as a high-flying insurtech that aimed to shake up the legacy insurance coverage business, Brilliant Well being has since seen its wings clipped. And even a latest company rebrand is unlikely to burnish its picture.
Within the third quarter of 2023, the corporate reported a $462.8 million working loss and in April opted to get out of the insurance coverage enterprise altogether. In January, it bought the remaining bits of that enterprise — two California Medicare Benefit plans — to Molina Healthcare for $500 million, $100 million much less than what was beforehand deliberate.
After jettisoning its insurance coverage enterprise, the corporate shifted focus to its present value-based client care enterprise known as NeueHealth. NeueHealth has two segments: NeueCare and NeueSolutions. NeueCare delivers “value-driven” care to shoppers throughout the ACA Market, Medicare and Medicaid by its owned clinics and partnerships with suppliers. NeueSolutions helps impartial suppliers and medical teams tackle value-based preparations by inhabitants well being instruments and partnerships with well being plans and authorities packages.
NeueHealth serves greater than 500,000 shoppers and companions with greater than 3,000 affiliated suppliers. Desirous to shake off associations with a failed enterprise in insurance coverage, Brilliant Well being introduced final month that NeueHealth could be its company model identify. It additionally moved its headquarters from Minneapolis, Minnesota to Doral, Florida.
However will a number of thousand miles and a brand new avatar save the corporate?
Nobody from NeueHealth agreed to be interviewed. A number of business specialists stated the corporate had no alternative however to rebrand given the shift in its focus however most weren’t bullish about its future.
“The identify could also be ‘neue’ however their issues are outdated,” quipped Ari Gottlieb, principal of A2 Technique Corp., in an interview. “It doesn’t change something. This was a essentially failed firm when its identify was Brilliant and it’s a failed firm when the identify is Neue. You may go away behind your outdated identify and the legacy that comes with it, however you’ll be able to’t go away behind your liabilities.”
The corporate is roughly $1.4 billion in debt, Gottlieb estimated. This contains cash owed to the Facilities for Medicare and Medicaid Companies (CMS) in threat adjustment funds, in addition to cash to Cigna Ventures, New Enterprise Associates and CalSTRS, he stated.
As well as, $100 million of its $500 million from its MA sale to Molina Healthcare is being put into an escrow account, by which a 3rd get together holds onto the funds till sure obligations are met, in line with an SEC submitting. The funds will likely be offered if there’s a profitable consolidation of Brilliant Well being’s two MA plans — Model New Day and Central Well being Plan — or if Model New Day is ready to obtain no less than three stars for its Half D plans from CMS. So there’s a risk that NeueHealth received’t even get all of this cash, Gottlieb stated.
Gottlieb added that the NeueHealth enterprise is just not value $1.4 billion, making it unlikely that it’ll survive.
“I simply assume this can be a zombie firm that no one cares about. … I believe they simply drain this after which file for chapter safety in March of 2025 earlier than they owe the federal authorities cash and there’s nothing anyone can do about it,” he stated.
One other knowledgeable echoed Gottlieb primarily implying the interior issues can’t be glossed over by a rebranding — though a rebranding was essential to direct focus to a consumer-focused enterprise.
“It’s altering the window dressing, but it surely doesn’t change something significant about their steadiness sheet,” stated Wesley Sanders, a well being plan advisor at Evensun Consulting, in an interview.
Sanders stated he anticipates NeueHealth both going below or being acquired, notably as a result of he hasn’t “seen something particular about their value-based care preparations that makes me assume that they’re going to have a greater mannequin than anyone else.”
In keeping with Gottlieb, a few of NeueHealth’s rivals within the value-based care area embody Cano Well being (which simply filed for chapter) and CareMax.
Whereas Gottlieb and Sanders don’t foresee a future for NeueHealth, one business follower has a extra optimistic view.
“Brilliant Well being is working in an enviornment that has numerous momentum and tailwinds as payers look to associate with organizations which can be prepared to take monetary threat for the care they’re offering,” stated Tyler Giesting, director of healthcare and life sciences at West Monroe, in an e mail. “Giant payers are vertically integrating by constructing or buying their method into the area NeueHealth operates in, which I’d anticipate to solely proceed.
“Between Medicare ACO, Medicare Benefit and Medicaid, there’ll proceed to be alternatives for them to assist suppliers transition to value-based preparations in new markets or to construct or purchase their very own clinics in new areas. I’d anticipate extra geographic enlargement as they construct further scale and develop lined lives.”
Unsurprisingly Mike Mikan, president and CEO of NeueHealth, stated in a information launch that he anticipates a optimistic future for the corporate.
“Taking the NeueHealth identify signifies our dedication to delivering worth by our differentiated care mannequin that uniquely aligns the pursuits of well being shoppers, suppliers, and payers. Our NeueHealth id has been a core and profitable a part of our group’s story, and we sit up for constructing on its robust efficiency as we take the lead within the business’s shift to value-based care.”
The sunny tone however, Giesting of West Monroe believes the corporate’s success will finally be decided by how properly its working and care fashions carry out in value-based contracts.
Photograph: carloscastilla, Getty Photos