Why Alignment CEO John Kao isn’t rushing expansion plans

Medicare Advantage company Alignment Healthcare on Aug. 3 announced it will expand into 16 new markets in 2022. The expansion will make the payer’s plan options available to a total of 6.9 million Medicare-eligible people in 38 markets across Arizona, California, Nevada and North Carolina.

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CEO John Kao told Becker’s Aug. 4 that future expansions of the Alignment Healthcare brand across state and county lines will happen, but not right away.

“We’re doing that in a very disciplined and methodical way because you can’t just go into a new market and put a dot on the map and say you’re growing. That’s not good enough,” he said. “You have to go to the market, you have to work with existing providers, and then you have to make sure that you can reproduce high quality at low cost, which means by definition, you have to implement our model, which is to know who the sick members are, give them extra good care, lower trend, and keep growing that way. And in order to do that, you need to have like-minded providers with you in the community. What we’ve been working on for the last couple of years is making sure that the workflow processes and management systems are in place to support that kind of growth.”

Alignment also announced new Medicare Advantage PPO plans designed to provide members with more personalized care in the wake of the pandemic. The plans will be available in 2022, pending regulatory approval.

“Between 84 to 87 percent of our members have been vaccinated, so I think we’ve done a pretty good job of keeping them safe,” Mr. Kao said. “I think that the adoption of virtual interactions is going to be more widely accepted going forward, particularly for safe follow-up kinds of visits. I think there’s still a bias from our seniors that they still, if possible, want to be seen by a doctor. But I think over time, as a combination of both the population ages with people that are more open to use of technology and virtual and digital solutions and as the aging population gets more comfortable with it, you’re going to see more and more of those virtual interactions. And I think in turn, you’re going to see more products being designed around those virtual interactions.” 

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