What organization would you rather be the CEO of:
Cigna and Express Scripts have received their parents’ the Justice Department’s blessing to go ahead with their wedding merger. The health insurer and pharmacy benefit manager say they’re a good fit for each other since they’ll be able to share information about their customers’ medical expenses that will help them manage patient health better. But the announcement has got to sting a bit for CVS Health and Aetna, who have been waiting on DOJ approval for their merger since before the Cigna-Express Scripts deal was announced. Visual/meme representation of that here. You’ve gotta think that Amazon’s ever-threatening encroachment into the healthcare industry is driving some of these vertical mergers between health insurers and PBMs.
A common theme in recent InsightCity stories is that if the market isn’t delivering the product consumers want, they’ll go and make it themselves. Turns out, the same thing applies for insurance. Some Americans fed up with the current system of high premiums and high deductibles are instead opting for health care sharing ministries. Essentially, these are groups that share healthcare costs amongst themselves but don’t accept risk and can deny coverage if you sustain injury doing something immoral, like crashing while drunk driving. And they’re growing; the IRS noted membership increases of 74 percent from 2014 to 2016, while a trade association for the groups cites nearly a million members. So maybe they’re just for the chosen few but expect to see them around.
From the “very cool” category comes a company called Bind. Billed (pun intended) as an on-demand provider of health insurance, Bind might be one of our favorite companies. Their tagline is InsightCity-ish and reads “Health insurance for everyone that suffers from health insurance.” Love it. With ~$70M in VC funding from folks like UnitedHealth and run by Tony Miller, former CEO of Definity Health, which was acquired by UnitedHealth in 2004 for $300M, Bind looks poised to take off. They offer the ability to purchase additional coverage whenever the consumer desires and their app provides cost/coverage quotes of treatments at different providers. According to Miller “When he and his team asked consumers what they want out of health insurance, they found that people think about insurance based on their individual health conditions. If a person has fibromyalgia, they would want a plan built around that.” Yea we do.
As insurers attempt to set health plan prices, they understandably try to pull in as much info as they can get their hands on. But patient advocates say they could be going too far by collecting ‘lifestyle data.’ That’s the subject of an NPR/ProPublica story on how providers are amassing a trove of data on consumers’ “race, education level, TV habits, marital status, net worth … what you post on social media, whether you’re behind on your bills, what you order online.” Insurers say they’re just using the data to improve patient outcomes, while companies that sell this data to insurers say it shouldn’t be used for pricing. But there’s not technically anything that would stop them from doing so, which is encouraging. Makes you want to live in Europe (kinda.)
There have been rumblings for a while now that Amazon would somehow be entering the healthcare space to shake things up. Well last week Amazon officially made its move, bringing heavy hitters Berkshire Hathaway and JP Morgan Chase along too. What do two of the world’s richest people and the leader of the US’s largest bank plan on doing exactly? That’s a great question, and we’d love to tell you if there were any kind of concrete details to explain the venture. We do know the goal is to “improve US employee satisfaction while reducing overall costs,” and that they plan to use technology to do it. Sounds vague, but the news was scary enough for investors sent insurer and drug store stocks tumbling after the announcement.