Bright Health Group to Further Focus on Delivering Affordable Healthcare to Aging and Underserved Populations Through Its Fully Aligned Care Model in Florida, Texas, and California
October 11 2022 - 7:00AM
Business Wire
- Reaffirms previous 2022 Adjusted EBITDA guidance at midpoint
and accelerates Adjusted EBITDA profitability to 2023, a year
earlier than previously anticipated
- Will no longer offer Individual and Family Plan products
through Bright HealthCare in 2023, or Medicare Advantage products
outside of California and Florida
- Raises $175 million of committed convertible preferred equity
capital to fully fund business to profitability
- Expects to deliver a $3 billion Net Revenue balanced business
in 2023 through its risk-bearing care delivery and Medicare
Advantage businesses
Bright Health Group, Inc. (“Bright Health”) (NYSE: BHG) today
announced its decision to further focus its business on its Fully
Aligned Care Model and will no longer offer Individual and Family
Plans through Bright HealthCare, or Medicare Advantage products
outside of California and Florida in 2023. In addition, Bright
Health announced raising $175 million of committed convertible
preferred equity capital that is expected to close in the coming
weeks and take the business through profitability.
Focusing on Bright Health’s largest healthcare markets where it
operates its differentiated Fully Aligned Care Model in partnership
with aligned external payors and care providers is a faster path to
profitability, has greater predictability, and is more capital
efficient. The company now expects to be profitable on an Adjusted
EBITDA basis in 2023 and will serve underserved populations through
its risk-bearing care delivery business, Medicare Advantage
products, and the ACO REACH Program in states that cover 26% of the
aging U.S. population. Further, given the continued solid
performance year-to-date, Bright Health Group reaffirms its
previous Adjusted EBITDA guidance for 2022 at the midpoint of the
range.
“We have demonstrated the power of the Fully Aligned Care Model
in serving aging and underserved populations and progressed the
marketplace towards seeing the promise in value-based care across
all populations,” said Mike Mikan, President and CEO, Bright Health
Group. “The changes announced today give Bright Health a strong and
stable platform for profitable growth at much lower risk. This is
one more strategic step to building a differentiated and profitable
business at scale.”
With this announcement, in addition to the previously announced
market exits, Bright HealthCare will not offer Individual and
Family health plans in Alabama, Arizona, Colorado, Florida,
Georgia, Nebraska, North Carolina, Texas, and Tennessee after
2022(1), or Medicare Advantage plans outside of California and
Florida. This focused footprint reduces Bright Health’s overall
regulated capital need and is expected to release excess regulated
capital of approximately $250 million upon settlement of all
medical liabilities and approval from state regulators.
Bright HealthCare will continue to meet its obligations and
service impacted members for the remainder of plan year 2022 and
will work to support all impacted members in the move to new plans
during the upcoming annual and open enrollment periods so that they
do not experience any interruption in their coverage. Members
enrolled in impacted plans will receive discontinuation letters, in
the near future. For more information, visit
https://brighthealthcare.com/markets.
(1) Bright HealthCare is in ongoing discussion on the
continuation for 2023 of an immaterial amount of Individual and
Family Plan business in certain states including California and
Colorado.
Conference Call
Bright Health Group will host a conference call to discuss
today’s announcement with investors at 8:30 a.m. Eastern Time
today. To participate via telephone, please register at this link.
Bright Health Group will also webcast this conference call live,
which can be accessed from the Investor Relations page of the
company’s website: investors.brighthealthgroup.com. Following the
call, a webcast replay will be available on the same site.
About Bright Health Group
Bright Health Group is a technology enabled, value-based
healthcare company that organizes and operates networks of
affiliate care providers to be successful at managing population
risk. We focus on serving aging and underserved consumers that have
unmet clinical needs through our Fully Aligned Care Model in
Florida, Texas and California, some of the largest markets in
healthcare where 26% of the U.S. aging population call home. We
believe everyone should have access to personal, affordable, and
high-quality healthcare. Our mission is to Make healthcare right.
Together. For more information, visit
www.brighthealthgroup.com.
Forward-Looking Statements
Statements made in this release that are not statements of
historical fact, including statements about our beliefs and
expectations, are forward-looking statements and should be
evaluated as such. Forward-looking statements include information
concerning possible or assumed future results of operations,
including descriptions of our business plan and strategies. These
statements often include words such as “anticipate,” “expect,”
“plan,” “believe,” “intend,” “project,” “forecast,” “estimates,”
“projections,” “outlook,” and other similar expressions. These
forward-looking statements include any statements regarding our
plans and expectations with respect to Bright Health Group, Inc.
and the closing of our committed convertible preferred equity
capital. Such forward-looking statements are subject to various
risks, uncertainties and assumptions. Accordingly, there are or
will be important factors that could cause actual outcomes or
results to differ materially from those indicated in these
statements. Factors that might materially affect such
forward-looking statements include: our ability to continue as a
going concern if we do not obtain additional financing; our ability
to comply with ongoing regulatory requirements, including consent
decrees or governmental orders; a lack of acceptance or slow
adoption of our updated business model; our ability to retain
existing consumers and expand consumer enrollment; our ability to
obtain and accurately assess, code, and report Individual and
Family Plan and Medicare Advantage risk adjustment factor scores
for consumers; our ability to contract with high-quality care
partners, maintain healthy relationships with them, and arrange for
the provision of quality care; our ability to accurately estimate
our medical expenses, effectively manage our costs and claims
liabilities or appropriately price our products and charge
premiums; our ability to obtain claims information timely and
accurately; the impact of the ongoing COVID-19 pandemic on our
business and results of operations; the risks associated with our
reliance on third-party providers to operate our business; the
impact of modifications or changes to the U.S. health insurance
markets; our ability to manage any growth of our business; our
ability to operate, update or implement our technology platform and
other information technology systems; our ability to retain key
executives; our ability to successfully pursue acquisitions and
integrate acquired businesses; the occurrence of severe weather
events, catastrophic health events, natural or man-made disasters,
and social and political conditions or civil unrest; our ability to
prevent and contain data security incidents and the impact of data
security incidents on our members, patients, employees and
financial results; our ability to comply with requirements to
maintain effective internal controls; our ability to adapt to the
new risks associated with our expansion into Direct Contracting /
ACO Reach program; adverse outcomes of regulatory investigations or
audits or lawsuits, actions or claims against us; our ability to
successfully exit insurance markets in a cost and resource
effective and efficient manner; and the other factors set forth
under the heading “Risk Factors” in the Company’s reports on Form
10-K and Form 10-Q (including all amendments to those reports) and
our other filings with the SEC. Except as required by law, we
undertake no obligation to update publicly any forward-looking
statements for any reason after the date of this release to conform
these statements to actual results or changes in our
expectations.
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