Anthem’s acquisition of Aspire Health, the nation’s biggest non-hospice, community-based palliative care provider, continues the health insurer race to own the cradle-to-grave health experience for patients, according to experts.
“The specific acquisition of Aspire Health, with its predictive analytics and comprehensive care team, appears to be additive to the care management capabilities of Anthem’s existing CareMore Health and AIM Specialty Health affiliates,” says Joseph Honcz, RPh, MBA, VP of Precision for Value’s Payer Access Solutions. “The question that remains is: How will the ‘extra layer of support’ that Aspire Health brings to the table be integrated into the Anthem business, and what value will it bring?”
Aspire currently provides services under contracts with more than 20 health plans to consumers in 25 states. The company also offers 24/7 support to patients, including nurse practitioner home visits.
"Insurers are defining avenues to help patients remain at home, reduce costs, and offer a more thoughtful integrated care approach," says Chris Hendrickson, managing director at Ziegler, a healthcare-focused investment bank. "We are clearly seeing a shift or broadening of those who will be aggregators of the home and community sector. There's a continued effort by managed care entities to enter the business of senior care management, in this case, palliative care. Over the last few years, managed care has further embraced end-of-life care and palliative care and are providing or partnering with entities to support their members during a very difficult time."
Here are five takeaways from the Anthem-Aspire acquisition:
- It is not yet clear if all the M&A activity by established insurers with national footprints can deliver on the local level, or if they will be outmoded by some disruptive startup. “What is clear is that the pursuit of value creation, either by vertical integration or adding adjacencies, seems to have increasing gravitational pull,” Honcz says.
- Health insurers know that they need to get smarter; as a result, they have often acquired new technology to prop up their aging infrastructure while turbocharging data collection and analytics. As insurers’ knowledge increases, it will bring opportunities to better humanize the insurance experience and offer the potential to improve health and outcomes, according to Honcz.
A prime example is, “Aspire Health proprietary predictive clinical and claims-based patient algorithms [can] identify patients with a serious illness who may benefit from an extra layer of support,” according to Honcz. “In the world of insurance, this is code for care optimization with an eye toward leveraging quality and cost management,” he says.
3. Large opportunity within caring and management of the sickest patients. “Thus, focus on developing models to support those with multiple chronic diseases and the dual eligible population,” says Hendrickson.
4. The chorus of consumer and patient voices on the ever-increasing cost of care continues to grow, with no real change in how much they pay. “It’s unclear how the trend of insurer acquisitions will deliver a solution to this pressing need,” Honcz says.
5. Advanced illness programs provide patient satisfaction, while reducing hospitalization and decreasing costs in general, according to Hendrickson.