An Uptick in Health Care M&As Is Just What the Doctor Ordered. Here’s One Risk Expert’s Prescription

By: | March 26, 2022

Les Williams, CRM, is Cofounder and Chief Revenue Officer of Risk Cooperative. He holds a B.S. in mechanical engineering from the University of Virginia and an MBA from Harvard Business School. Prior to joining Risk Cooperative, Les served in various institutional sales positions at SoHookd, JLL, and IBM.

Anthem BCBS is diversifying its positioning in the marketplace by rebranding itself as Elevance Health Inc.

On its website, Anthem states, “We’re not changing the way we do business, we’re transforming from a traditional health benefits organization to a lifetime, trusted health partner. Through our digital capabilities, data and resources, we are uniquely able to champion a whole-health approach and advance health beyond health care for our consumers, their families and our communities.”

Anthem aims to address physical, behavioral and social drivers that impact health through technology, not simply focus on the physical treatment aspect of health care that insurers typically target.

Anthem has experienced a slew of recent acquisitions: In April 2021 the acquisition of home-based nursing management company mYNEXUS was completed; in March 2020 it acquired the behavioral health organization Beacon Health Options; and during the fall of 2017, Anthem launched IngenioRX, a pharmacy benefit manager utilizing AI and data analytics to deliver better pharmacy care for consumers.

Given Anthem’s renewed focus on the implementation of technology to improve health care, its rebranding comes as no surprise.

Follow the Leader

Anthem is not alone in the quest to broaden its value proposition via technology.

CVS Health’s acquisition of Aetna in 2018 was designed to help the consumer integrate various aspects of health care delivery, like access to nutrition and choosing the right health plan, while harnessing technology to help consumers schedule care and connect with medical professionals virtually or in-person at MinuteClinic locations.

In January 2021, Optum (a UnitedHealth Group company) and Change Healthcare announced plans to merge with the goal of leveraging their technologies to bolster data analytics, resulting in streamlined administrative and payment processes with the goal of lowering costs and providing better patient outcomes (the Justice Department is currently challenging this merger, citing antitrust concerns).

Cigna is no stranger to vertical integration. In 2018 it acquired Express Scripts, a large pharmacy benefit manager with the goal of lowering health care costs by managing medical and pharmacy benefits.

A few years later in 2020, Cigna rebranded its health services line as Evernorth, which will include Express Scripts and other technology-driven health care solutions like virtual care delivery platforms and specialized pharmacies.

A Renewed Focus on Prevention

The ever-expanding web of services being offered by health insurers has a positive outcome beyond the ability to simply lower costs in the health care delivery value chain; the acquisition of certain technology solutions allows big data to be the “new microscope” in preventative health care.

Using data analytics to better predict and treat ailments will improve patient outcomes by reducing hospital stays, decreasing the quantity of drugs needed to treat ailments, and decreasing the likelihood of medical errors when treating patients.

Of particular interest are acquisitions that include platforms focusing on preventative health measures.

According to The Goodness Web, a nonprofit focused on accelerating preventative mental health initiatives, over 90% of all national mental health organizational dollars go towards treatment instead of education or prevention.

Anthem’s acquisition of Beacon Health Options is one example of a health insurer bucking this trend, offering preventative mental health services in accessible, heavily trafficked retail locations like Walmart. Beacon Health feels that “by improving access to care, people can address their behavioral health and wellness concerns before they turn into bigger, more serious problems.”

We can expect more health insurers to acquire companies like SoHookd, a wellness-oriented benefits, rewards and gifts platform that aggregates offerings like healthy meal delivery, online meditation, virtual fitness and other self-care measures that encourage healthy behavior among its users.

Adopting a healthy lifestyle is a major preventative strategy decreasing the likelihood of developing maladies like diabetes, cancer and heart disease.

The growing footprint of health insurers will make us a more resilient society, especially those acquisitions focused on preventative measures utilizing technology.

The coronavirus continues to test the mettle of our health care system, but when — not if — the next pandemic arrives on our shores, the “new look” of health insurers will be a major reason why our nation will prevail. &

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