Bright Health Group is significantly reducing its business operations and will no longer offer individual and family health plans through Bright Healthcare or offer Medicare Advantage plans outside California and Florida.
The company also said it has raised $175 million in outside capital to "take the business through profitability," which it expects in 2023. Bright will continue to participate in CMS' ACO REACH program and operate its value-based care delivery business, NeueHealth, according to an Oct. 11 news release.
Bright Healthcare's total enrollment as of June 30 was 970,000 members. Medicare Advantage members stood at 120,000, along with 500,000 NeueHealth members.
Bright executives had told Florida regulators in August there was "substantial doubt" the company could remain financially viable without additional outside investment.
On Aug. 10, the company released its second-quarter earnings that showed a net loss of nearly $432 million in the first half of 2022. The payer has been using reserve funds to cover its losses and created a special committee to actively raise capital.
During a call with investors, CEO Mike Mikan said the company had always planned to look for additional outside investment to break even.
In 2022, the company exited the individual and group markets in Alabama, Arizona, Colorado, Florida, Georgia, Illinois, Nebraska, New Mexico, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Utah and Virginia. It also said it is in "ongoing discussions" about continuing to offer individual and group plans in California and its PEAK plan in Colorado.
Bright Health members and providers will see no changes in 2022, and the payer says it will help transition affected individuals to new plans during the next open enrollment cycle to avoid coverage disruptions.