Entrepreneurs Aim to Capitalize on Healthcare Reform
THE NUMBERS: CHILDREN
- 8.6% of deliveries in Florida are low birth weight (less than 5?pounds). Nationwide, the percentage is 8.1%.
- The infant death rate per 1,000 births in Florida is 7.2. Nationwide, the rate is 6.8.
- 70.6% — Florida mothers initiating breast-feeding at birth (33rd)
- 15.2% of high school students were at risk of being overweight in 2007 and an additional 11.2% were overweight.
- 62.3% of high school students did not participate in any physical education at school in 2007.
- 22.1% of high school students ate five or more servings of fruits or vegetables each day during the past seven days.
Company: Avalon Healthcare, Tampa, approved to do business in 2005 by the Florida Office of Insurance Regulation
Trend: High-deductible policies
CEO: Chuck O’Neill, a co-founder of the company, was co-founder and director of Oxford Benefit Management.
Distinction: The first new healthcare plan approved to do business statewide in more than a decade
Customers: 10,000 individual and group members in the Tampa Bay area, southwest Florida and Broward and Palm Beach counties. Avalon plans to expand into the Orlando market but has decided not to do business in Miami-Dade and south Broward counties.
Customer Base: 80% of customers are individuals.
Features: Most popular plans have deductibles between $2,000 to $5,000, co-pays of $25 to $35 for a primary care physician, with Avalon paying 100% after the customer meets the deductible. A 35-year-old, male non-smoker in Pinellas County would pay about $111 per month for a plan with a $5,000 deductible, 100% co-insurance and drug benefits with no deductible. A plan with a $1,000 deductible, 80/20 co-insurance and drug benefits would cost about $156.
Economies: Avalon is more restrictive than most plans in working only with hospitals that will meet its cost requirements. HCA hospitals are not a part of its network, for example.
Revenue: Avalon expects to bring in premiums of $20 million this year, up from $9 million in 2008.
Business Plan: The company is looking for expansion capital.
THE NUMBERS: OBESITY
Of adults who are obese:
- 68% are inactive
- 45% have high cholesterol
- 43% have high blood pressure32% have arthritis
- 7% have diabetes
- 17% smoke
- 13% have cardiovascular disease