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Meridian Health partnership aims for Medicare Advantage market in Monmouth, Ocean

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Meridian Health CEO John Lloyd knows the lines between payers and providers are blurring rapidly, so with an eye to the future, the system today announced a partnership that will give patients a new opportunity to access Medicare Advantage coverage.

Meridian signed a joint venture agreement with Pennsylvania-based Geisinger Health, a nationally recognized hospital system, to offer Geisinger Health Plan’s Medicare Advantage plan to seniors in Monmouth and Ocean Counties. The plan is called Geisinger Gold, which the namesake health system has been offering since 1994.

Lloyd said Meridian hopes to enroll 3,000 to 5,000 people in the Geisinger Gold plan within the first year of offering it. Three insurers currently offer Medicare Advantage plans in Monmouth and Ocean counties – which have some of the highest concentrations of senior populations in the state – but have a small penetration into the market, less than 15 percent, according to Meridian. Medicare Advantage plans cover services not covered by traditional Medicare and supplemental coverage plans.

Besides provides an additional outlet for Medicare Advantage for the 231,000 seniors in the two counties, the partnership with Geisinger aligns with Meridian’s goals, Lloyd said.

“One of our goals when we created Meridian, which was 15 years ago, was to create a fully integrated health system. We’ve worked very hard to get where we are today, where we have a very high degree of integration,” Lloyd said. “Over the last few years, with the advent of health reform, we have been working even harder to better integrate … care delivered to the patient. We spent an enormous amount of time doing that.”

Nationally, Lloyd estimates there are nearly 70 hospital systems that have their own health insurance plans. This isn’t Meridian’s first foray into the insurance world – the system was a founding partner of QualCare Inc. And while QualCare is a different insurance structure than Medicare Advantage, Lloyd said the experience has provided valuable knowledge about how payers and providers are working together.

“We’ve always believed that partnering and aligning on the insurance side is important because in the future, the lines are becoming blurred,” Lloyd said. “Everybody is trying to find the best combination of organizations and competencies that will deliver a new product in the future. And that product is no more fragmented health care, but really a truly integrated approach.”

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