You’ll need a large data application simply to help keep tabs on that is purchasing whom вЂ“ Anthem purchasing Cigna, United buying Aetna, or Aetna buying Humana. Many speculate that independent Blues will quickly follow, whether or not it is consolidating under Anthem or HCSC or several other umbrella. The one thing is obvious: the landscape for nationwide health plans is changing extremely quickly.
This consolidation has huge implications for wellness systems, doctor teams, specialty providers, and post-acute providers in the united states. Let’s briefly examine some of the opportunities, and commence to believe through the implications for payor/provider agreement negotiations, brand brand new and risk that is innovative, and re payment prices for all health plans maybe maybe not mixed up in consolidation.
Situation No. 1: Anthem Buys Cigna
This deal brings along with it some dynamics that are really interesting. First, Anthem may be operating in most 50 states as opposed to the 14 where in fact the ongoing business currently runs. 2nd, Anthem is amongst the least trusted health plans by providers, and Cigna happens to be tops (or near tops) for many years. 3rd, Cigna’s existence when you look at the big team nationwide company market as well as its HealthSpring platform introduce significant brand new abilities to Anthem’s portfolio.
One other significant implication facilities on rates. Cigna is normally an extra- or third-tier payor for providers, with less share of the market and greater re re re payment prices compared to the market frontrunner. Will Anthem let Cigna access its reduced prices in states where there clearly was a delta between your two, thus eliminating a few of the inter-payor expense shift that providers count on to help keep the operational system in stability?Read More »Without a doubt about What an Anthem-Cigna wedding method for the marketplace