Photo: Morsa Images/Getty Images

Healthcare insurtech Oscar Health will be expanding its presence on the Affordable Care Act marketplace in 2025 and is introducing new plans for people with multiple chronic conditions.

Healthcare insurtech Oscar Health将于2025年扩大其在《平价医疗法案》市场的影响力，并为患有多种慢性病的人推出新计划。

The company will expand into 405 markets across 18 states next year, it said.

该公司表示，明年将扩展到18个州的405个市场。

Oscar is launching a multi-condition plan for members with diabetes, pulmonary and cardiovascular disease – three common conditions impacting ACA members, it said. Internal research showed managing those conditions can lower costs by up to 25%.

Oscar正在为患有糖尿病、肺部疾病和心血管疾病的会员推出一项多病种计划，这三种常见疾病会影响ACA会员。内部研究表明，管理这些条件可以将成本降低高达25%。

Benefits of the plan include no out-of-pocket costs for cardiologists, pulmonologists, endocrinologists, screenings and labs, primary and behavioral care, and medications.

该计划的好处包括心脏病专家、肺科医生、内分泌学家、筛查和实验室、初级和行为护理以及药物治疗不需要自付费用。

Members can enroll in Oscar's single-condition plans, Diabetes Care and Breathe Easy, in select states.

在选定的州，会员可以参加奥斯卡的单一条件计划、糖尿病护理和放松呼吸。

Meanwhile, employees can now choose from a suit of offerings using their employer contributions. Individuals can select from several plans with high-quality networks that align with their schedules, neighborhoods and health needs, Oscar said, adding that it has a dedicated concierge team for employees that is available 24/7 to help them maximize the new benefits..

与此同时，员工现在可以使用雇主的捐款从一套产品中进行选择。奥斯卡说，个人可以从几个计划中进行选择，这些计划具有与他们的时间表、社区和健康需求相一致的高质量网络，并补充说，它有一个专门的员工礼宾团队，可以全天候为员工提供服务，帮助他们最大限度地享受新的利益。。

Oscar is working with StretchDollar to help businesses with fewer than 50 employees offer pre-tax contributions that employees can use to buy individual health insurance, it said.

它表示，奥斯卡正在与StretchDollar合作，帮助员工少于50人的企业提供税前供款，员工可以用来购买个人健康保险。

WHAT'S THE IMPACT

有什么影响

In addition, Oscar is introducing Buena Salud, a Spanish-first offering for Hispanic and Latino members. Individuals engage with Oscar in Spanish and are connected to a care team and primary care provider that shares the language.

此外，奥斯卡还推出了布埃纳·萨卢德（BuenaSalud），这是西班牙首次为西班牙裔和拉丁裔成员提供服务。。

Buena Salud builds on the Hola Oscar offering, which has a Spanishspeaking net promoter score (NPS) of 87 and is available across Oscar plans, the company said. The program, developed by native Spanish-speakers at Oscar, accounts for cultural, linguistic and regional differences among Hispanic and Latino communities.

布埃纳·萨卢德（BuenaSalud）以霍拉·奥斯卡（Hola Oscar）为基础，该公司表示，霍拉·奥斯卡（Hola Oscar）的净推荐分数（NPS）为87，可在奥斯卡计划中使用。该项目由奥斯卡的西班牙语母语人士开发，解释了西班牙裔和拉丁裔社区之间的文化、语言和地区差异。

These communities make up nearly one-third of Oscar's membership and, according to the Department of Health and Human Services, are the fastest-growing populations in the ACA..

这些社区占奥斯卡成员的近三分之一，根据卫生与公众服务部的数据，这些社区是ACA中增长最快的人口。。

Oscar is also introducing Guided Care HMO, with lower premiums and out-of-pocket costs. Individuals select a primary care provider who manages their care with a network of specialists, and Guided Care HMO delivers urgent and real-time referrals, with benefits including $0 virtual urgent care, $0 medications, and low-cost labs and integrated virtual-first speciality care..

奥斯卡还推出了引导式护理HMO，它具有较低的保费和自付费用。个人选择一家初级保健提供者，该提供者通过专家网络管理他们的护理，引导护理HMO提供紧急和实时转诊，其好处包括0美元的虚拟紧急护理，0美元的药物治疗，低成本的实验室和集成的虚拟第一专业护理。。

THE LARGER TREND

更大的趋势

Oscar named Mark Bertolini as its new chief executive officer in 2023. Bertolini is former chairman and CEO of Aetna. During his tenure at Aetna, Bertolini led the company's transition from a traditional health insurance company to a consumer-oriented healthcare company.

2023年，奥斯卡提名马克·贝托利尼为新任首席执行官。Bertolini是安泰保险前董事长兼首席执行官。贝托利尼（Bertolini）在安泰（Aetna）任职期间，领导该公司从传统的健康保险公司过渡到面向消费者的医疗保健公司。

In 2022, Oscar Health and Bright Health said they were pulling back on their Medicare Advantage business to focus more on ACA plans.

2022年，奥斯卡健康保险公司（Oscar Health）和光明健康保险公司（Bright Health）表示，他们将退出医疗保险优势业务，更多地关注ACA计划。

Jeff Lagasse is editor of Healthcare Finance News.Email: jlagasse@himss.orgHealthcare Finance News is a HIMSS Media publication.

杰夫·拉加西是《医疗保健金融新闻》的编辑。电子邮件：jlagasse@himss.orgHealthcare《财经新闻》是HIMSS的媒体出版物。