There were more than 2,700 Medicare Advantage (MA) plans available for individual enrollment in 2019, an 18% bump compared to last year. The number of active MA plans is projected to increase even further in 2020, thanks to federal health care policymakers’ concerted efforts to broaden the program and address social determinants of health.

Launched in August by the American Medical Association spinoff Health2047, Zing Health is just one of the up-and-coming MA players to enter the picture.

Currently eyeing underserved markets in the Midwest, the tech-enabled Zing Health has a two-fold mission: to elevate the patient-provider relationship and alleviate social barriers that impact its members’ well-being.

“The Zing team believes that — a great majority of the time — the U.S. health care system has its priorities misplaced,” CEO Dr. Eric Whitaker told Home Health Care Newes in an email. “Academic studies support that over 80% of one’s health is determined by factors other than the clinical health services one receives.”

On a high level, social determinants of health include individuals’ access to transportation and food, in addition to their ability to connect with friends and family.

“SDoH” may have become buzzworthy in 2019, but home health and home care providers have been tackling social challenges for years.

That’s why Zing Health — co-founded by TWG Partners’ Whitaker and Harthavan Capital’s Dr. Ken Alleyne — sees at-home care organizations as valuable allies moving forward.

“In the view of the founders of Zing Health, the home health and home care industries have been at the vanguard of caring for patients in the setting that is most important in health — the home,” Whitaker said. “Zing Health looks forward to partnering with such companies in the communities where we offer Medicare Advantage. Together we can improve health outcomes for our patients.”

While it has its sights set on the Midwest, Zing Health is first launching in Cook County, Illinois, with coverage starting in 2020.

As part of that coverage, enrolled members will have access to Zing health field teams, made up of experienced nurses, behavioral health specialists, community health workers and care managers, among others.

“We believe focus needs to evolve from the hospital being the main focus to the community and to the home,” Whitaker told HHCN. “In our view, community-based care providers take on [greater] importance than those who are hospital-based.”

Zing Health is the third company to come out of Health2047, the Silicon Valley business formation and commercialization enterprise launched by AMA in 2016.

Although the Centers for Medicare & Medicaid Services (CMS) expanded Medicare Advantage in 2018 and in 2019 when it comes to in-home supports tied to social determinants of health and chronic conditions, those moves did not factor into Zing Health’s launch, according to Whitaker. 

“The changes in the Medicare Advantage program over the past several years did not influence our decision to launch Zing Health,” Whitaker said. “[But] we were heartened that CMS began to acknowledge the importance of community-based care provision and that of social determinants of health. Their policy moves validated our initial thoughts about how we desired to incentivize care.”

Apart from Zing Health, Anthem Blue Cross and Blue Shield in Maine and MaineHealth also announced plans to collaborate on an MA joint venture in August.

Named AMH Health LLC, the JV’s goal is to leverage each partner’s assets to better care for seniors.

Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans of Maine Inc. and an independent licensee of the Blue Cross Blue Shield Association.

Meanwhile, MaineHealth is a nonprofit integrated health system consisting of eight local hospital systems, a comprehensive behavioral health care network, diagnostic services, home health agencies and more than 1,500 employed and independent physicians working together through an Accountable Care Organization (ACO).

“With this joint venture, we saw an opportunity to bring together the core strengths of the region’s leading health care system and health insurance provider,” Dr. Betsy Johnson, president of the MaineHealth ACO and an executive sponsor of the new JV. “Our goal is to create a Medicare option that will support healthy aging for Maine seniors with a comprehensive approach to care.”

Citing Medicare regulations, Johnson declined to comment on whether the emerging MA flexibilities related to in-home care factored into the creation of the new JV.

“Medicare regulations do not allow us to discuss the features such a plan might have until the open enrollment period begins in the fall,” she said.

Additional reporting by Bailey Bryant