Specialist
Former executive at Devoted Health Inc
Agenda
- Recent trends and developments in the Medicare Advantage value-based health plan market
- Devoted Health’s aggressive expansion plans into different states and membership growth marketing initiatives
- Competitive landscape and ability to carve out market share against legacy Medicare Advantage managed care organisations, including UnitedHealth (NYSE: UNH), Humana (NYSE: HUM) and Elevance Health (NYSE: ELV)
- Devoted Health’s competitive advantage in network coverage and cost containment strategy
- Pricing considerations for 2023, capital deployment efforts and exit opportunities
Questions
1.
What major trends and developments have you been following in the value-based health plan space over the past 12 months or so that might better inform our discussion on Devoted Health?
2.
Could you expound on your initial description of Devoted as a trailblazer, especially the personalised approach to senior healthcare and how this differentiates the company from other value-based insurtech health plans, such as Clover Health, Bright and Oscar Health?
3.
How do you assess Devoted’s membership growth strategy and ability to grow its Medicare Advantage plan network? What initiatives have the company’s sales and marketing team employed to build brand recognition and grow the patient base efficiently in new markets?
4.
How competitive is the Medicare Advantage health plan market currently? Is this causing any downwards pressure on plan pricing or an impetus to expand the benefit mix?
5.
Could you outline the plan tiers and options available to patients? What are the main plans and benefit mixes offered at the zero-dollar premium level up through the USD 45-50-per-month range?
6.
What are typical bundled payments like on managed populations in Medicare Advantage, perhaps in terms of PMPM [per member per month]?
7.
How would you juxtapose the benefits and drawbacks of having an owned network of clinicians vs the anchor partner model Devoted has historically employed?
8.
What incentives does Devoted offer to anchor partners to demonstrate that it is an attractive plan to work with, especially considering industrywide clinician supply shortages?
9.
What mix do you think Devoted will strike between in-house clinical staff or Devoted Medical group vs partnering over the longer term? What are the main strategic or financial considerations there?
10.
How does Devoted help support its in-network clinicians and anchor partners to help reduce clinician burden via administrative tasks? To what extent does the company assist with provider credentialing, licensing, billing, etc?
11.
Where do you think Devoted will deploy capital in 2023 to further grow the business? Which avenues of capital spend make the most strategic sense to continue to expand prudently?
12.
We’ve seen many similar start-up health plans struggle with expanding too quickly and managing cost of care in newer markets. How has Devoted been able to avoid some of those hurdles and maintain profitability as it scales?
13.
Do you have any use cases or examples to show how tech assets or engagement initiatives might translate into better costs of care?
14.
What’s been Devoted’s approach to ensuring accurate risk coding and patient onboarding in newer markets? What’s been the strategy to engage with members or understand the demographics to better manage cost of care over the longer term?
15.
Looking at the competitive landscape, how do you think the large managed care organisations such as UnitedHealth or Humana view Devoted? Do they see the company’s meteoric rise and growth as a threat, or is there plenty of runway in the Medicare Advantage market to go around?
16.
We saw some of the large Medicare Advantage plans take quality hits on CMS star ratings this past annual enrolment period. How much of an opportunity do you think Devoted has to gain market share at their expense? What are the switching costs for seniors to hop between plans?
17.
What’s the likelihood we could see a large health plan purchase Devoted at some point? Would this be more of a member acquisition play, a defensive strategy or perhaps for the tech assets?
18.
You’ve mentioned the uniqueness and superior value prop of the tech infrastructure. Do you think there’s an opportunity to license any of the technology out to other health plans at some point? Would Devoted even consider this?
19.
Could you elaborate on Devoted’s management team, leadership style and company culture? How does this impact the company’s operational outlook?
20.
How are you gauging the longer-term threat of CMS [Centers for Medicare and Medicaid Services] stepping in and capping bundled payments to organisations such as Devoted? If lucrative savings are being realised, why wouldn’t the US government step in to reduce its own cost burden? I know this has been a priority for the Biden administration.
21.
What might be 1-2 major business risks to Devoted over the next 3-5 years, and why?
22.
Is there anything we’ve not touched on that might be important to highlight about Devoted?
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