Insurers are exploring vertical deals after their horizontal merger plans were blocked. Their odds are looking much better this time around.
A year ago, four major health insurance companies were reevaluating their business strategies after their plans to pair off and form two even bigger insurance companies were blocked to preserve competition.
Within the first six weeks of 2017, one federal judge blocked Aetna’s plan to buy Humana, and another blocked Anthem’s plan to buy Cigna. Each judge cited antitrust laws, saying the deals could harm consumers.
Today, however, it seems most of the four insurers have moved on to new potential partners—with verticality in mind.
Citing unnamed sources, The Wall Street Journal reported Thursday evening that Walmart is “in preliminary talks” to purchase Humana. This news comes after CVS Health announced plans in December to buy Aetna for $69 billion and Cigna announced plans in March to buy Express Scripts, a pharmacy benefit manager (PBM), for $54 billion.
The prospective Walmart-Humana deal looks an awful lot like the CVS-Aetna arrangement insofar as each transaction would combine a PBM with pharmacies and health insurance.
That seems like a logical setup for Walmart, according to J. Mario Molina, MD, president of Golden Shore Medical Group, which operates clinics in four California counties.
“Walmart already has a massive pharmacy infrastructure & has tried venturing into in-store clinical care,” Molina, who was president and CEO of Molina Healthcare Inc. until last year, wrote in a tweet Friday. “Plus, with 1.5M U.S. employees, it makes sense when trying to optimize healthcare costs.”
Looking to compete
Humana, like every other major player in the healthcare space, is competing not only for market share but also for control of how patients and money flow through the system, according to Erik Gordon, clinical assistant professor in the University of Michigan Ross School of Business.
Steven Porter is editor at HealthLeaders.