Though the partnership with Oscar Health was announced shortly after Anthem Blue Cross Blue Shield announced it would quit the Affordable Care Act exchange, the Clinic said the timing was a coincidence. The Clinic had been working on a partnership with Oscar for more than a year.
"We want to make sure that we are accessible to all of our community, and we really didn't feel like we had appropriate access points within the individual insurance marketplace," Sears said.
The new "Cleveland Clinic | Oscar" individual health plans, which will be sold both on and off the Ohio health insurance exchange, represent Oscar's first entrance into the Ohio market as well as the Clinic's first co-branded narrow network product.
Oscar was founded in 2012 with the goal of helping consumers to navigate their health care, said Mario Schlosser, Oscar CEO and co-founder. A computer scientist by training, Schlosser was inspired to launch Oscar after his wife's pregnancy, during which he struggled to understand his choices, their costs and how to get the information he needed to make decisions. Schlosser launched the company with Josh Kushner — the younger brother of Jared Kushner and brother-in-law of Ivanka Trump.
"Health care is a complex system — that is clear — but it felt to me somebody ought to be better at helping me navigate that system," he said. "We felt that the insurance company really is a critical component in that journey of a patient, because the insurer knows so much about you as a patient and about the health care system that it helps operate."
Though the Clinic has participated with other insurance companies in the individual segment, those have been in broader network offerings. Operating on a narrow network, the partnership with Oscar also brings unique consumer-focused technology that allows patients to contact the insurance company, schedule appointments, see medical history and much more.
The Clinic pairs its care teams with "concierge teams" at Oscar, which are made up of a handful of care guides and a nurse.
"It's the Amazon experience, if you will, of getting health care," Schlosser said. "You click the button, we tell you where you can go right this moment, and we'll get you in."
Powering this technology requires a deeper level of collaboration behind the scenes. Oscar and the Clinic have been working to integrate their back-end systems and connect existing capabilities.