NEW YORK, Jan. 11, 2022 /PRNewswire/ -- COPE Health Solutions partnered with eternalHealth to create the first licensed start-up health plan in Massachusetts since 2013. Boston-based eternalHealth is now live and accepting members for its new consumer-centric Medicare Advantage Prescription Drug (MAPD) plan in Massachusetts--one that is locally owned, community-focused, and targeting women, who are usually the health care decision-makers for their families.
Founded in 2019 by CEO Pooja Ika, eternalHealth is a consumer-centric, woman-owned and –operated health insurance company that delivers affordable, high-quality care to beneficiaries. Through its technology-driven platform, eternalHealth will substantially reduce its SG&A costs across the entire enterprise, allowing for these costs savings to be passed down to their members through robust plan designs and reduced out-of-pocket costs. eternalHealth is committed to offering a differentiated product that is focused on member engagement, education, and empowerment so that its members can make informed decisions about their care. Dedicated to female empowerment in its community and beyond, eternalHealth has committed to ensuring more than 50% of its employees, executives, board of directors, and investors are women.
"eternalHealth brings a fresh and compelling strategy for providing affordable care through a tailored health plan for seniors," said Yomi Ajao, COPE Health Solutions' Chief Consulting Officer and President of its subsidiary Analytics for Risk Contracting, and who was instrumental in shaping the plan and securing all necessary licenses and approvals. "This Medicare Advantage plan is run by a diverse leadership team and staff that live in eternalHealth's service area and have a deep personal understanding of beneficiaries' needs."
A national leader in consulting, solutions and services for health plans, risk-bearing organizations and providers, COPE Health Solutions leveraged its deep experience and expertise in Medicare Advantage, medical management, analytics, financial modeling, network analytics and network development, and contracting to collaborate with eternalHealth to develop the MAPD plan. MAPD plans combine Medicare benefits with prescription drug coverage so beneficiaries don't need to buy a separate Part D drug plan. The COPE Health Solutions team also led the application and approval process with the Centers for Medicare & Medicaid Services (CMS) and the state of Massachusetts for the plan and provided interim clinical leadership to support the initial infrastructure build.
"Since day one, COPE Health Solutions has been a true partner and guided us through this heavily regulated process. Together, both the eternalHealth and COPE Health Solutions team brought my vision to life. With their help, eternalHealth is one step closer to being a catalyst for change, by making health care more accessible and affordable for those who need it the most." said Ika. "We were in unchartered water when we started the licensure process, but by working closely and navigating through obstacles, we were able to accomplish a lot in a very short period of time. COPE Health Solutions' knowledge and enthusiasm in guiding us to this point has been invaluable."
In addition to offering the MAPD plan, eternalhealth is furthering its mission by holding culturally competent member events and outreach in neighborhoods across the service area. The company is also addressing social determinants that diminish health equity. These efforts include partnering with community-based organizations to close gaps in access to healthy food and conducting local outreach campaigns in diverse and underserved neighborhoods to eliminate disparities in both health outcomes and hesitancy to access healthcare services engendered by systemic racism.
About COPE Health Solutions
COPE Health Solutions is a national healthcare consulting, implementation and co-management leader in population health management, value-based care and payments, workforce development and data analytics. We offer the experience, tools, services and advice that health plans and providers need to meet strategic goals and thrive in the complex and uncertain health care environment. We are driven by our passion to help transform healthcare delivery, align financial incentives to support population health management and build the workforce needed for value-based care.
About eternalHealth
Founded by Pooja Ika, eternalHealth is a Medicare Advantage plan that provides high-quality care with low out-of-pocket costs to the residents of Massachusetts. eternalHealth is committed to placing their member at the forefront of every decision they make as an organization. Women-run, built, and owned, eternalHealth offers HMO and PPO products in three Massachusetts counties: Worcester, Middlesex, and Suffolk. For more information about eternalHealth's plans and services, please visit www.eternalHealth.com.
eternalHealth's cloud-based platform that embraces robotic process automation (RPA), machine learning (ML), and artificial intelligence (AI), will substantially reduce administrative and avoidable medical costs currently plaguing industry competitors and accounting for nearly a quarter of all medical spend in the US. The platform streamlines thousands of traditionally fragmented, transactional functions that are managed by fifteen to twenty siloed departments, onto one end-to-end platform that delivers actionable intelligence to help drive care management optimization to stakeholders across the spectrum of care. Furthermore, this actionable data helps providers collaboratively manage patient outcomes with the health plan. Through the platform, eternalHealth is able to provide a defined roadmap to risk and a comprehensive view of patient cost and quality improvement opportunities captured by integrating all provider activity at the point of care during every patient encounter.
As a result, members can look forward to more premium dollar spent on medical benefits, not administrative waste, and providers can look forward to a reducing their administrative burden, improving patient outcomes, and closing gaps in care.
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SOURCE COPE Health Solutions
