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After much discussion and consideration, the ACHE Board of Governors and leadership team have decided to cancel the 2020 Congress on Healthcare Leadership due to the need for leaders and healthcare organizations to manage their responses to coronavirus (COVID-19) within their communities. Learn more at

45B – Medicare Advantage 101: Lessons Learned From a Provider-Sponsored Health Plan

Tuesday, March 24th

About the Session

It took more than seven years of careful consideration and planning, but in 2019, BayCare Health System launched its provider-sponsored health plan, BayCare Health Plans. BayCare, a not-for-profit health system, is the largest health system in the Tampa Bay area and serves more than one-third of the community. As a community-owned organization, BayCare believed that by offering its own health plan, it could provide a more affordable, higher quality level of care than what was currently available in the market. With that goal in mind, BayCare Health Plans entered the market with two Medicare Advantage HMO Plans under the BayCarePlus Medicare Advantage name.

On October 1, 2018, BayCare unveiled its new health plan and began to market BayCarePlus Medicare Advantage. In what is a highly competitive market, BayCare was able to capture 1 percent of the market share in its first enrollment period in a market that is traditionally dominated by insurance giants. BayCarePlus recruited the second highest number of net new Medicare Advantage members in the market and received national attention for the effectiveness of its branding. Despite its many successes, BayCarePlus identified several key opportunities for improvement in its launch year. From network strategy to sales distribution, there were several lessons learned. This seminar will explore those lessons with applicability to your own organization as you consider building a provider-sponsored health plan.

Learning Objectives:

  • Identify the reasons why a health system may choose to enter the health insurance market and the questions it should ask to determine its readiness.
  • Analyze the top 10 lessons learned from starting a provider-sponsored health plan and how to apply them to your organization.


Presented By

Edward M. Rafalski, PhD, FACHE

Senior Vice President/Chief Strategy and Marketing Officer
BayCare Health System

Kristy Croom Tucker

Director, Marketing Health Plans
BayCare Health System

Patrick Cimino, MD

CMO, BayCare Solutions
BayCare Health System