When insurtech Vivid 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, Vivid 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 offered 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 current value-based shopper care enterprise referred to as NeueHealth. NeueHealth has two segments: NeueCare and NeueSolutions. NeueCare delivers “value-driven” care to customers throughout the ACA Market, Medicare and Medicaid by means of its owned clinics and partnerships with suppliers. NeueSolutions helps impartial suppliers and medical teams tackle value-based preparations by means of inhabitants well being instruments and partnerships with well being plans and authorities applications.
NeueHealth serves greater than 500,000 customers and companions with greater than 3,000 affiliated suppliers. Wanting to shake off associations with a failed enterprise in insurance coverage, Vivid Well being introduced final month that NeueHealth can be its company model title. 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 selection however to rebrand given the shift in its focus however most weren’t bullish about its future.
“The title could also be ‘neue’ however their issues are previous,” quipped Ari Gottlieb, principal of A2 Technique Corp., in an interview. “It doesn’t change something. This was a basically failed firm when its title was Vivid and it’s a failed firm when the title is Neue. You’ll be able to depart behind your previous title and the legacy that comes with it, however you may’t depart behind your liabilities.”
The corporate is roughly $1.4 billion in debt, Gottlieb estimated. This consists of 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, through which a 3rd occasion holds onto the funds till sure obligations are met, in accordance with an SEC submitting. The funds might be supplied if there’s a profitable consolidation of Vivid Well being’s two MA plans — Model New Day and Central Well being Plan — or if Model New Day is ready to obtain at the least three stars for its Half D plans from CMS. So there’s a chance that NeueHealth gained’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 suppose this can be a zombie firm that no person cares about. … I believe they only 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 — despite the fact that a rebranding was essential to direct focus to a consumer-focused enterprise.
“It’s altering the window dressing, nevertheless it doesn’t change something significant about their steadiness sheet,” stated Wesley Sanders, a well being plan guide 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 suppose that they’re going to have a greater mannequin than anyone else.”
In line with Gottlieb, a few of NeueHealth’s opponents 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.
“Vivid Well being is working in an area that has quite a lot of momentum and tailwinds as payers look to accomplice with organizations which are 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 electronic mail. “Massive payers are vertically integrating by constructing or buying their approach 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 growth as they construct extra scale and develop coated 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 title signifies our dedication to delivering worth by means of our differentiated care mannequin that uniquely aligns the pursuits of well being customers, 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 nicely its working and care fashions carry out in value-based contracts.
Photograph: carloscastilla, Getty Pictures
