Oxbridge Health (“Oxbridge”) will leverage nirvanaHealth’s Aria Payer & PBM platform to administer its innovative Episode Benefit plans, an entirely new category of health insurance plan design that integrates familiar features of PPO and HMO plans, while using episode allowances to drive radical levels of cost transparency. The new plans will begin enrolling self-funded employers starting in 2024.
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“The platform empowers Payers to distribute risk via innovative contracting with physicians/hospitals, IPAs, ACOs, and Bundled Payment programs.”
The Aria platform-as-a service will be deployed by Oxbridge to administer key features of Episode Benefit Plans, including enrollment, billing and collections, claims administration and provider network management. These capabilities will be linked to the Oxbridge platform to enable creative use of bundled payments and episode of care allowances in benefit plan designs.
“We are excited to work with Oxbridge to drive innovation and to help them launch with a highly competitive cost structure. We believe it can become a showcase for our range of capabilities,” says Ravi Ika, founder and CEO of nirvanaHealth.
The Oxbridge platform has been designed to move up to 50% of an employer’s annual health benefit spending into episode of care programs. This enables a radical level of transparency into the underlying costs of care and gives covered beneficiaries a way to avoid the crushing out of pocket costs that have become standard in traditional HMOs and PPO plans. Episode Benefit Plans represent the first truly unique new health benefit offering since the introduction of PPOs and Point of Service Plans in the late 1980s.
Oxbridge chose the nirvanaHealth platform because of its modern underlying architecture and ability to integrate with Oxbridge’s software and services. “Ravi and his team have a long history of building great software that successfully tackles some of the most complex challenges in health benefits administration,” says Steve Wiggins, the Chairman of Oxbridge Health. “I am excited about our partnership with nirvanaHealth and the potential of our partnership to drive innovation while creating a more efficient and responsive health plan.”
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Oxbridge was founded by an experienced team who previously founded Oxford Health Plans, HealthMarket, and Remedy Partners. Oxford grew to be a fortune 300 company before it was sold to United Healthcare and Remedy Partners grew to become the largest bundled payment program serving Medicare.
Episode Benefit Plans will initially be offered through Oxbridge Health to employers who self-fund their employee benefit plans will be offered as fully insured benefit plans by 2025. Employers can choose these plans to replace their current health insurance offering to employees, or as an option alongside other benefit plan offerings.
The Aria platform was designed to administer any type of health benefit program, whether a Medicare or Medicaid plan, a commercial health insurance program, an employer self-funded plan or prescription drug programs. “We created Aria with flexibility in mind, capable of administering both government and commercial health plans, along with all of the underlying risk programs and innovative contracting that drive cost control,” says John Sculley, the Chairman of nirvanaHealth and the former CEO of Apple. “The platform empowers Payers to distribute risk via innovative contracting with physicians/hospitals, IPAs, ACOs, and Bundled Payment programs.”
“Aria serves incumbents and innovators by addressing their most complex software challenges and lowering the cost of administering their benefit plans and risk arrangements,” adds Ika. With built-in artificial intelligence (AI), machine learning (ML), and robotic process automation (RPA), Aria facilitates risk mitigation among payers and care delivery entities and helps them manage cost and improve quality.
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