Anthem UnitedHealth probe, no plans to go on a medical care.
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 their 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) in 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 more than 9,000 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 67,000 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.
“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,” said Paul Marchetti, Anthem’s senior vice president of 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.”