Health insurer Anthem has no plans to go on a
medical care provider-buying spree like its chief rival UnitedHealth Group, the
nation’s largest health insurer.
That was one of the key messages of Anthem CEO
Gail Boudreaux and her management team Thursday in its annual investor day
presentation in New York to discuss the health insurer’s strategy as it relates
to medical care providers. Insurers are forming closer ties with doctors,
hospitals and other medical care providers in hopes of reduce costs and
improving health outcomes.
Though Anthem has purchased some doctor practices in
Florida and — like Unitedhealth and Cigna — already owns its
own pharmacy benefit manager (PBM) IngenioRx, the nation’s second-largest
health insurer is more interested in partnering with doctors and clinics than
buying them. Anthem operates Blue Cross and Blue Shield plans in 14
states.
UnitedHealth, which owns the large Optum
health services businesses, has spent billions of dollars buying doctor
practices and urgent care centers and has a pending deal yet to close with
DaVita Medical Group. Meanwhile, CVS Health, which owns thousands of pharmacies
and more than 1,100 retail health clinics, spent $70 billion buying Aetna, the
nation’s third-largest health insurance company.
“The bottom line: we don’t have to own care
provider practices, but we can enable our partnerships to define, create and
deliver value,” Boudreaux said Thursday in her presentation, which was webcast.
Other executives said Anthem would be looking
at acquisitions but those would be purchases largely designed to build on
existing businesses.
“We are partnering with our providers,” said
Dr. Prakash Patel, executive vice president and president of Anthem’s
diversified business group. He said Anthem wants to provide doctors services to
help them better manage their practices and the patients they are treating.
By partnering rather than buying doctor
practices, Anthem executives said it doesn’t hurt the insurer’s ability to
offer its employer and government clients value-based programs designed to make
sure healthcare is delivered in the right place, at the right time and in the
right amount.
“Anthem’s 'Enhanced Personal Health
Care,' our largest value-based program, is helping strengthen our care
provider relationships,” Boudreaux said. “Today, we have 6.2 million members,
166 accountable care organizations and 67 thousand care providers. By 2023, we
plan to have in excess of 11 million patients aligned with value-based care
providers.”
Anthem executives said there are other
ways to lower healthcare costs in the communities where they sell health
insurance through medical care provider partnerships. In New Hampshire, for
example,
“We are sponsoring a new 50,000 sq. ft.
medical complex in New Hampshire, to house primary care, internal medicine,
lab, and specialists in a lower cost setting,” Paul Marchetti, Anthem’s Senior
Vice President, Network and Care Delivery Transformation. “As a sponsor, Anthem
will have exclusivity on product Alignment, with lower copays to encourage
members to use the new complex.”
For more
information on healthcare, read Bruce Japsen's book, Inside
Obamacare: From Barack And Michelle To The Affordable Care Act.
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