Florida Blue’s Truli for Health HMO Targeted to Small and Mid-Sized Employers

GuideWell entered the market in 2014, employing approximately 6, 500 people and operated in a handful of states. Today, GuideWell is made up of more than 13, 000 employees and serves 27 million people across 35 states, plus Washington D.C., the U.S. Virgin Islands and Puerto Rico.

GuideWell is more than a health insurance company. With five distinct business units (Florida Blue, GuideWell Health, GuideWell Source, GuideWell Connect and PopHealthCare), GuideWell is a family of companies focused on reimagining how health care can and should be delivered.

Florida Blue, Florida’s Blue Cross and Blue Shield company, has been providing health insurance to residents of Florida for more than 75 years. The company serves more than 5 million health care members across the state. In total, Florida Blue and its affiliated companies serve 27 million people in 35 states.

Florida Blue recently introduced Truli for Health (Truli), an affiliate of Florida Blue and an independent licensee of the Blue Cross and Blue Shield Association, as a new health maintenance organization designed to provide Florida’s small and medium-sized employers with affordable, quality health insurance solutions for their employees.

Truli will expand health care coverage options for local businesses through partnerships with community healthcare providers. It will first launch in Central and select South Florida counties on July 1, 2020. Truli operates with four strategic pillars:

• Personalized benefits to support chronic care management and consumerism
• A highly curated network
• A more integrated Plan/Provider operating model
• Engaged and financially aligned delivery model

For product salability to local employer groups, Truli’s GuideWell Health Plan (GWHP) will be an open access HMO. The GWHP product promotes access to high value care — care that provides the best health results for patients at the right price, in the right setting, for the right reason enabled through just-in-time data analytics.

Truli’s network of anchor providers in these counties include: Baptist South Florida (specifically Bethesda Hospitals and outpatient centers, Bethesda Health Physician Group, Boca Raton Regional Hospital and BocaCare physician group), Cleveland Clinic Florida (specifically Weston Hospital, Martin North Hospital, Martin South Hospital, Tradition Hospital and Indian River Hospital), HCA Central Florida, Jupiter Medical Center, Orlando Health, Pediatric Associates, Wellington Regional Medical Center, plus Sanitas Medical Centers, GuideWell Primary Care and GuideWell Emergency Doctors.

In addition, Truli also includes the use of a Center of Excellence program with Mayo Clinic in Jacksonville, giving members with rare and complex conditions access to Mayo Clinic’s world-renowned knowledge and expertise.

Takeaway: Truli’s Value-Based Insurance Design (VBID) promotes patients’ use of high-value care options by reducing cost sharing for treatments providing increased clinical value