The investment arm of Marietta, Ga.-based Wellstar Health System, Catalyst by Wellstar, has invested in Venteur, a digital health startup that administers Individual Coverage Health Reimbursement Arrangement plans.
ICHRAs allow employers to contribute tax-free dollars to employees’ health benefits, which employees can then use to purchase an ACA plan.
ICHRA adoption has grown by more than 1,000% since 2020, with employers of all sizes continuing to adopt the insurance model at double-digit growth year after year. More than 260,000 U.S. employees have been offered ICHRA or QSEHRA coverage for plan year 2025, and more than 13,000 U.S. businesses are participating in the ICHRA and QSEHRA ecosystem as of January 2025. The overall market is broadly estimated to contain between 500,000 to 1 million covered lives.
Becker’s sat down with John Cooper, vice president of venture investments at Wellstar and head of venture investment for Catalyst by Wellstar, to learn more about why the health system is backing this new insurance model.
Question: Why did Catalyst by Wellstar want to move into the realm of health insurance innovation?
John Cooper: It’s definitely a different way of doing health insurance. We’re used to a model where everyone works for their company and then receives group health coverage. The ICHRA market allows for more customization. We found it very interesting in terms of the direction it could potentially lead the overall market.
We’re always out there trying to learn what’s new. We’re asking, how can we tie this into the health system? How is this going to potentially affect our patients? How will it affect how they access the hospital and our providers? That was definitely the case here. This has the potential to disrupt things, so we’re working with the Venteur team to understand what this new market looks like and how our patients may benefit from it.
Q: How do you see the ICHRA market continuing to evolve?
JC: Based on our research, a lot of these plans are targeting small and mid-sized employers right now and how they can work there. But the big question that remains is: Could this potentially move into the large market in terms of employers that extend across multiple states? Could they leverage this instead of working with other potential payers out there? I think that remains to be seen.
If we start seeing some of these large employers shifting to an ICHRA plan or an ICHRA-style plan from a traditional group plan, I think that would be a huge game-changer.
Q: Why did Venteur stand out as a partner?
JC: What really stood out to us about Venteur specifically was the team. Their CEO, Stacy Edgar, is a very dynamic individual and a great leader, and they have the resources to take care of their customers. We put them through a very rigorous process, and every step of the way, they approached it as an opportunity, not just to help answer our questions, but to educate us and make sure we understood the opportunity. I think they have a lot of success ahead of them because of how they continue to approach everything this way.
Q: What would you say to other hospitals’ leadership about prepping for where this market is going?
JC: Given the traction we’re seeing with this and the potential for continued growth, I think it’s important to understand how this changing dynamic could affect how hospitals interact with patients and how it will change the top line of a health system.
It’s better to strategize and understand: If there continue to be major shifts in the payer market and the design of that market, how does that affect us? If I have a patient coming in for a knee replacement, one coming into the emergency department, or interacting with their primary care physician, how is the overall payment and reimbursement structure going to work?
CEOs, revenue cycle management teams, and the payer contracting teams within health systems need to really look at this and understand what could happen if this structure continues to gain share. We don’t show the future, but you don’t want to be caught off guard.
