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Anthem CEO discusses firm’s strategy in a churning sector

Anthem President and CEO Joseph Swedish talked at  the America’s Health Insurance Plans (AHIP) Institute & Expo 2017 about affordability, access and care quality as the healthcare sector continues to be churned by unprecedented change.

Research has shown that providing better care at a lower cost is “truly an achievable goal,” Mr. Swedish said, and he outlined the strategy that the huge insurer is  taking to reach it.

This includes, as summarized by Healthcare Dive:

1.  Promoting consumer choice and market competition

2. Simplifying the healthcare experience

3. Supporting partnerships in all levels of government

Mr.  Swedish says that Anthem  expanded “very aggressively” in the government sector after purchasing Medicaid provider Amerigroup.

4. Converting volume to value.

Anthem is now “paying 59 percent of reimbursement to the provider community through value-based care models,” he  said.

5. Addressing the impact of chronic disease in our society

6. Supporting clinical innovations

Mr. Swedish cited Anthem’s recent creation of  an innovation studio to better understand customers’ needs, how to model innovations applicable to them and how to bring them to the market rapidly.  An example: The studio’s initiative  called “What’s My Status?” This sends updates to members about  their claim status and  data on their healthcare spending.

7. Leveraging big and deep data and technology

“This will reset the playing field between patient and doctors,” he added. “It’ll make them [doctors] a whole lot more capable.”

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Architects of insurance mega-merger plans

 

A look at Aetna chief executive Mark Bertolini, who has struck a $34 billion deal for Aetna to buy Humana, and Anthem CEO Joseph Swedish, who has a deal for Anthem to buy Cigna for $48 billion.

 

The merger plans won’t necessarily go smoothly: The Justice Department is leery of huge concurrent transactions in the managed-care industry. And hospital officials and physician groups, fearing cuts in their revenues because of the  new behemoth insurers’ bargaining power, oppose  the acquisitions. Further, two congressional committees have scheduled hearings for the fall on the mergers.

As The Wall Street Journal noted,  the “Aetna deal would create by far the biggest player in the private-insurer version of Medicare, so concern over market concentration will focus on the companies’ footprint in that business, known as Medicare Advantage. Mr. Bertolini said that the vast majority of Medicare Advantage consumers have at least five options currently, so ‘we don’t see a reduction in competition for consumers’ from the Humana deal.”

“He argues that the merged company will be better positioned to work closely with health-care providers and the federal government to bring down costs and improve quality.”

 

 

 

 

 


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