What Lies Ahead for Healthcare Solutions
Change is afoot for Healthcare Solutions, the parent company of Cypress Care, Procura Management, ScripNet and Modern Medical. The company’s acquisition by Catamaran closed on April 8. Catamaran, in turn, will be purchased by UnitedHealth, according to a late March announcement. Risk & Insurance® discussed the implications of the Catamaran acquisition with Joe Boures, CEO of Healthcare Solutions.
Healthcare Solutions made a major announcement recently, how do you expect this change to impact your clients?
The acquisition will have a positive long-term impact on our clients but our primary focus right now is making sure that we continue to service our customers with the same discipline and focus as we do today. Our client service model is staying the same so clients should not feel a disruption in service upon close of the acquisition.
Some acquisitions result in the need to re-implement a program as changes occur to the company’s technology platform. In our case, since Healthcare Solutions’ technology platform is already integrated with Catamaran, there is not a need to re-integrate with our customers as a result of the acquisition. This will allow us to stay focused on current initiatives to make our delivery of medical management services as impactful as possible.
How do you see this change playing out for the future of the company?
Without a doubt, the acquisition will have a positive impact on the future of the company. It provides Healthcare Solutions a stable ownership structure in a rapidly consolidating marketplace, along with access to the resources of a $20 billion company.
Catamaran has a long history in the workers’ compensation space and this is an area of investment for the company. Customers will benefit from the combined organization.
Do you expect your role to remain the same?
Yes, I’ll move over as a senior leader of the workers’ compensation business, with similar functions as I have today.
The last few years saw a lot of consolidation in the workers’ comp industry. Do you think we can expect to see more consolidation going forward and why?
Short answer, yes. The primary reason is that there are still a lot of private equity-owned companies with needed exit strategies. There’s also competitive pressures that will ultimately lead to a consolidated marketplace.
You talk to a lot of customers. What are the key challenges your customers tell you they are facing?
Customers continue to be challenged by medical cost inflation coupled with appropriate utilization controls. Healthcare Solutions’ customers are responsible for coordinating appropriate care for injured workers. They are concerned about injured worker safety and outcomes while also being mindful of spend.
If you just look at pharmacy as a microcosm of medical management, customers are concerned about the increase in compound drugs and physician dispensed drugs, as well as the potential over-prescribing of narcotic opioids. These issues alone are concerning to our customers from both a cost and safety point of view.
At the end of the day, customers are looking for how to do more with less. As businesses operate in leaner environments, they are looking for partners and technology solutions they can leverage to have the greatest impact on their programs.
You’ve been in this space for more than 20 years. What is the most significant advancement you’ve seen?
Technology as an enabler to create seamless business processing, which allows many of our products to truly become programs within our customer base. Though we’ve come a long way, there are more efficiencies to be gained. Both claimant-centric and process-centric technology solutions will continue to evolve and add value for customers.
How has your training as an accountant benefited you as a workers’ compensation executive?
The workers’ compensation industry has and will continue to focus on bottom line results. Having an accounting background allows me to deeply understand relationships around how to drive outcomes-based programs in ways others without that experience are at a disadvantage.
But while an accounting background allows one to understand the language of business, there’s so much more to being an effective workers’ compensation executive. Financial spreadsheets don’t allow you to hear the voice of the customer. I believe that you have to spend a lot of time meeting with and listening to customers. Our business is a people business and top leaders need to have both financial discipline and as well as connectivity with their customers.
We know you’re from Philadelphia Joe, so tell us…where do you get the best cheesesteaks?
Without a doubt, Joe’s Steaks + Soda Shop on Torresdale Avenue. Although this isn’t really a fair question, given that my brother-in-law owns the restaurant.
You don’t have to rely on my opinion though, Joe’s Steaks + Soda Shop is consistently acknowledged as one of Philly’s best cheesesteaks by locals.