Besides trying to grab more of the very lucrative Medicare Advantage business of Humana, which it seeks to buy, Aetna hopes to create a health-services division with Humana’s other assets.
As Modern Healthcare noted: “It’s a sign that even the largest health insurance companies realize they must do more than just sell health insurance if they want to remain at the top of the food chain in the long term. UnitedHealth Group has embraced this model through its Optum subsidiary. ”
Consider that Humana controls America’s fourth-largest pharmacy benefit manager, which lets it negotiate “prescription drug prices on its own instead of outsourcing. It has also invested in the clinically based Humana At Home division, which helps seniors transition out of the hospital and into their homes.”
“Aetna could create its own version of Optum, which is built primarily around clinical consulting, data analytics and drug management. While Humana has the clinical and pharmacy parts, Aetna has the healthcare information technology components, which include Healthagen and Bswift. Healthagen works with hospitals and health systems on accountable-care contracting, and Bswift is a technology company focused on private exchanges.”