{"id":147103,"date":"2021-09-15T15:00:38","date_gmt":"2021-09-15T14:00:38","guid":{"rendered":"https:\/\/clarivate.com\/?p=147103"},"modified":"2024-10-24T00:26:53","modified_gmt":"2024-10-24T00:26:53","slug":"healthcare-consolidation-paves-way-for-care-delivery-changes","status":"publish","type":"post","link":"https:\/\/clarivate.com\/life-sciences-healthcare\/blog\/healthcare-consolidation-paves-way-for-care-delivery-changes\/","title":{"rendered":"Healthcare consolidation paves way for care delivery changes"},"content":{"rendered":"<p><em>Clarivate U.S.\u00a0market\u00a0access experts\u00a0discuss on recent mergers,\u00a0cause of these mergers\u00a0and their impact\u00a0on the\u00a0healthcare\u00a0system. Read more.\u00a0<\/em><\/p>\n<p>Changes in the\u00a0U.S.\u00a0healthcare industry, many of which were prompted by the pandemic, are driving consolidations to cover gaps in care and stabilize revenue streams.\u00a0Payers\u00a0are\u00a0engaging in non-traditional mergers,\u00a0such as\u00a0the\u00a0announcement by\u00a0<a href=\"https:\/\/www.unitedhealthgroup.com\/newsroom\/2021\/2021-01-06-optuminsight-and-change-healthcare-combine.html\" target=\"_blank\" rel=\"noopener\">UnitedHealth Group\u2019s<\/a>\u00a0Optum\u00a0unit\u00a0to buy Change Healthcare\u00a0to strengthen its analytics,\u00a0technology\u00a0and revenue cycle management capabilities. Payers are also focusing on horizontal mergers to strengthen their market position\u00a0like many provider groups across the nation.\u00a0Telehealth\u00a0claims\u00a0increased\u00a0significantly\u00a0due to COVID-19, which led to a\u00a0flurry of merger deals in\u00a0the\u00a0telehealth space\u00a0that were\u00a0uncommon pre-pandemic.\u00a0All of\u00a0this consolidation activity is changing the way healthcare will be delivered in the future.<\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"font-size: 14px\"><strong>Chart 1: Telehealth utilization in the United States<\/strong><\/span><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-147931\" src=\"http:\/\/clarivate.com\/life-sciences-healthcare\/wp-content\/uploads\/sites\/4\/2021\/09\/telehealth_claims_count.jpg\" alt=\"\" width=\"885\" height=\"437\" srcset=\"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-content\/uploads\/sites\/4\/2021\/09\/telehealth_claims_count.jpg 885w, https:\/\/clarivate.com\/life-sciences-healthcare\/wp-content\/uploads\/sites\/4\/2021\/09\/telehealth_claims_count-300x148.jpg 300w, https:\/\/clarivate.com\/life-sciences-healthcare\/wp-content\/uploads\/sites\/4\/2021\/09\/telehealth_claims_count-768x379.jpg 768w, https:\/\/clarivate.com\/life-sciences-healthcare\/wp-content\/uploads\/sites\/4\/2021\/09\/telehealth_claims_count-81x40.jpg 81w\" sizes=\"auto, (max-width: 885px) 100vw, 885px\" \/><\/p>\n<p><span style=\"font-size: 14px\"><em>Source: Clarivate Real-World Data<\/em><\/span><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<h2>Payer-provider integration\u00a0in\u00a0recent years<\/h2>\n<p><a href=\"https:\/\/investors.centene.com\/news-events\/press-releases\/detail\/72\/centene-completes-acquisition-of-wellcare-creating-a\" target=\"_blank\" rel=\"noopener\">Centene\u2019s acquisition of WellCare<\/a>\u00a0was undoubtedly\u00a0one\u00a0of\u00a0the largest\u00a0consolidations\u00a0in managed care\u00a0in 2020. Overall merger activity is higher\u00a0in\u00a0the\u00a0eastern United States\u00a0as\u00a0this region\u00a0is concentrated\u00a0with\u00a0hospitals and\u00a0health systems,\u00a0and\u00a0health systems\u00a0are\u00a0known to engage in\u00a0integration with other providers\u00a0to\u00a0solidify their presence.\u00a0With\u00a0geographical expansion\u00a0due to mergers,\u00a0providers can expect\u00a0an increase\u00a0in\u00a0their\u00a0negotiating clout.<\/p>\n<p>A few notable\u00a0examples include:<\/p>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>The merger between\u00a0<a href=\"https:\/\/revcycleintelligence.com\/news\/atrium-health-wake-forest-baptist-health-finalize-merger\" target=\"_blank\" rel=\"noopener\">Atrium Health<\/a>\u00a0and Wake Forest Baptist Health\u00a0has had far reaching influence\u00a0as it affects\u00a0North Carolina, South Carolina, Georgia and Virginia.<\/li>\n<li><a href=\"https:\/\/decisionresourcesgroup.com\/blog\/molinas-hunt-grab-small-mcos-expands-growth-new-markets\/\" target=\"_blank\" rel=\"noopener\">Molina Healthcare<\/a>\u00a0acquired three health plans strengthening its Medicaid business in Kentucky, New York, Virginia,\u00a0Florida\u00a0and Arizona.<\/li>\n<li>Highmark and\u00a0HealthNow\u00a0merger\u00a0in New York\u00a0makes\u00a0Highmark\u00a0the\u00a0<a href=\"https:\/\/www.bcbswny.com\/content\/wny\/about\/news\/latest\/highmark-affiliation-completion-announcement.html\" target=\"_blank\" rel=\"noopener\">fourth largest<\/a>\u00a0Blue Cross plan\u00a0in the\u00a0United States.<\/li>\n<li><a href=\"https:\/\/ir.antheminc.com\/news-releases\/news-release-details\/anthem-inc-acquire-mmm-holdings-llc-and-affiliates-innovacare?field_nir_news_date_value%5Bmin%5D=\" target=\"_blank\" rel=\"noopener\">Anthem<\/a>\u00a0acquiring\u00a0InnovaCare\u2019s\u00a0subsidiary\u00a0MMM\u00a0holdings in Puerto Rico is an example of a payer expanding its presence\u00a0via merger,\u00a0as Anthem had very little enrollment in\u00a0Puerto Rico previously.<\/li>\n<li><a href=\"https:\/\/www.floridablue.com\/newsroom\/guidewell-aquires-triple-s\" target=\"_blank\" rel=\"noopener\">GuideWell\u00a0Mutual Holding Corporation<\/a>, the parent company of Blue Cross and Blue Shield of Florida (Florida Blue),\u00a0announced plans to acquire Puerto Rico-based Triple-S Management for $900 million. Triple-S Management is the largest insurer in Puerto Rico.\u00a0If this deal goes through,\u00a0GuideWell\u00a0will own the biggest insurer of Florida and Puerto Rico\u00a0residents.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><span style=\"font-size: 14px\"><strong>Chart 2: Payer and provider mergers in the United States<\/strong><\/span><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-147640 size-full\" src=\"http:\/\/clarivate.com\/life-sciences-healthcare\/wp-content\/uploads\/sites\/4\/2021\/09\/consolidation_blog_2.jpg\" alt=\"\" width=\"862\" height=\"474\" srcset=\"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-content\/uploads\/sites\/4\/2021\/09\/consolidation_blog_2.jpg 862w, https:\/\/clarivate.com\/life-sciences-healthcare\/wp-content\/uploads\/sites\/4\/2021\/09\/consolidation_blog_2-300x165.jpg 300w, https:\/\/clarivate.com\/life-sciences-healthcare\/wp-content\/uploads\/sites\/4\/2021\/09\/consolidation_blog_2-768x422.jpg 768w, https:\/\/clarivate.com\/life-sciences-healthcare\/wp-content\/uploads\/sites\/4\/2021\/09\/consolidation_blog_2-860x474.jpg 860w, https:\/\/clarivate.com\/life-sciences-healthcare\/wp-content\/uploads\/sites\/4\/2021\/09\/consolidation_blog_2-73x40.jpg 73w\" sizes=\"auto, (max-width: 862px) 100vw, 862px\" \/><\/p>\n<p><span style=\"font-size: 14px\"><em>Source: Clarivate Lives Data, July 2020<\/em><\/span><\/p>\n<p>&nbsp;<\/p>\n<h2>Telehealth\u00a0mergers\u00a0surge with increase in telehealth usage<\/h2>\n<p>In June and July 2020,\u00a0the numbers of\u00a0U.S.\u00a0physicians conducting\u00a0virtual patient consults\u00a0had doubled\u00a0in comparison\u00a0to\u00a0late March and April 2020,\u00a0according to a\u00a0survey done by\u00a0<a href=\"https:\/\/clarivate.com\/blog\/telehealth-stay-unprecedented-times-drive-innovation\/\">Clarivate<\/a>.\u00a0The telehealth industry is expected to see a compound annual growth of 18.43%\u00a0and reach\u00a0$22.92 billion by\u00a0<a href=\"https:\/\/www.medgadget.com\/2021\/02\/u-s-telehealth-market-size-2021-share-latest-technology-growth-with-industry-analysis-report-by-trends-covid-19-impact-top-companies-polycom-siemens-healthineers-bosch-american-well-biotele.html#:~:text=Telehealth%20Market%20is%20valued%20at,18.43%25%20over%20the%20forecast%20period.\" target=\"_blank\" rel=\"noopener\">2025<\/a>.<\/p>\n<p>Mergers\u00a0and acquisitions\u00a0involving telehealth companies\u00a0include:<\/p>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>Teladoc Health and\u00a0<a href=\"https:\/\/www.teladochealth.com\/newsroom\/press\/release\/teladoc-health-completes-merger-with-livongo\/\" target=\"_blank\" rel=\"noopener\">Livongo<\/a>,<\/li>\n<li>Cigna\u00a0and\u00a0<a href=\"https:\/\/www.fiercehealthcare.com\/payer\/cigna-s-evernorth-completes-acquisition-virtual-care-provider-mdlive#:~:text=Cigna&#039;s%20Evernorth%20has%20completed%20its,efforts%20to%20lower%20healthcare%20costs.\" target=\"_blank\" rel=\"noopener\">MDLive<\/a>,<\/li>\n<li>Grand Rounds,\u00a0which is\u00a0in\u00a0the\u00a0care-navigation business\u00a0and\u00a0<a href=\"https:\/\/grandrounds.com\/announcement\/merger\/\" target=\"_blank\" rel=\"noopener\">Doctor on Demand<\/a>,<\/li>\n<li>Walmart\u00a0and\u00a0<a href=\"https:\/\/corporate.walmart.com\/newsroom\/2021\/05\/06\/walmart-health-to-acquire-telehealth-provider-memd\" target=\"_blank\" rel=\"noopener\">MeMD<\/a>, and<\/li>\n<li>UpHealth\u00a0Holdings and\u00a0Cloudbreak.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><span style=\"font-size: 14px\"><strong>Chart 3: Payer mergers and number of lives impacted<\/strong><\/span><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-147642 size-full\" src=\"http:\/\/clarivate.com\/life-sciences-healthcare\/wp-content\/uploads\/sites\/4\/2021\/09\/consolidation_blog_3.jpg\" alt=\"\" width=\"936\" height=\"413\" srcset=\"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-content\/uploads\/sites\/4\/2021\/09\/consolidation_blog_3.jpg 936w, https:\/\/clarivate.com\/life-sciences-healthcare\/wp-content\/uploads\/sites\/4\/2021\/09\/consolidation_blog_3-300x132.jpg 300w, https:\/\/clarivate.com\/life-sciences-healthcare\/wp-content\/uploads\/sites\/4\/2021\/09\/consolidation_blog_3-768x339.jpg 768w, https:\/\/clarivate.com\/life-sciences-healthcare\/wp-content\/uploads\/sites\/4\/2021\/09\/consolidation_blog_3-91x40.jpg 91w\" sizes=\"auto, (max-width: 936px) 100vw, 936px\" \/><\/p>\n<p><span style=\"font-size: 14px\"><em>Source: Clarivate Lives Data, July 2020<\/em><\/span><\/p>\n<p>&nbsp;<\/p>\n<h2>COVID-19\u00a0and its impact on mergers and acquisitions<\/h2>\n<p>The ongoing COVID-19 pandemic has been a hurdle for completion of some\u00a0potential mergers,\u00a0such as\u00a0the\u00a0<a href=\"https:\/\/cancerletter.com\/covid-19-cancer\/20200508_3\/\" target=\"_blank\" rel=\"noopener\">Fox Chase Cancer Center<\/a>\u00a0and Thomas Jefferson University deal. At the same\u00a0time,\u00a0COVID-19 prompted the\u00a0acquisition of\u00a0Passport Health Plan by\u00a0<a href=\"https:\/\/investors.molinahealthcare.com\/news-releases\/news-release-details\/molina-healthcare-announces-closing-its-acquisition-passports\" target=\"_blank\" rel=\"noopener\">Molina<\/a>, as\u00a0Passport faced financial difficulties after the loss of its managed care contract\u00a0due to\u00a0the pandemic.<\/p>\n<p>Some deals, such as the\u00a0<a href=\"https:\/\/investors.centene.com\/news-events\/press-releases\/detail\/6\/centene-signs-definitive-agreement-to-acquire-magellan\" target=\"_blank\" rel=\"noopener\">Centene<\/a>\u00a0and Magellan Health\u00a0merger, focus on priorities beyond expansion,\u00a0such as behavioral health services or\u00a0payment processes. The pandemic has placed\u00a0more emphasis on\u00a0the need for a\u00a0virtual healthcare system,\u00a0increased\u00a0mental health\u00a0support\u00a0and systems to handle the surge in claims.<\/p>\n<p>While telehealth\u00a0usage\u00a0decreased in 2021\u00a0(Clarivate\u00a0claims data, as of July 2021),\u00a0it\u00a0is not expected\u00a0to\u00a0regress\u00a0to pre-pandemic usage.\u00a0Telehealth\u00a0became popular\u00a0among\u00a0patient\u00a0with\u00a0behavioral health\u00a0concerns (Clarivate claims data, as of July 2021) \u2014\u00a0making a strong case for more consolidation\u00a0deals\u00a0involving\u00a0organizations\u00a0that support these\u00a0services.\u00a0Additionally, the\u00a0rise in\u00a0<a href=\"https:\/\/clarivate.com\/blog\/digital-pharmacies-posed-growth-post-pandemic-world\/\" target=\"_blank\" rel=\"noopener\">digital<\/a>\u00a0and virtual care companies\u00a0have helped\u00a0level\u00a0the\u00a0playing field\u00a0for small insurers\u00a0by\u00a0simplifying\u00a0access to care.\u00a0We expect\u00a0the volume of mergers\u00a0to continue\u00a0to increase\u00a0as the industry rebounds from the pandemic\u00a0and the economy stabilizes.<\/p>\n<p><em>Contributors to this blog include\u00a0Nishitha N. Prabhu, Senior\u00a0Analyst;\u00a0Lonita Lobo, Analyst;\u00a0Upamanyu Mondal, Research\u00a0Associate; and\u00a0Krishna Gandhi, Research Associate.\u00a0<\/em><\/p>\n<p><strong>Get a comprehensive and granular view of the healthcare ecosystem and market dynamics and how to break down barriers to access with\u00a0<a href=\"https:\/\/clarivate.com\/products\/biopharma\/market-access\/\">Clarivate market access intelligence<\/a>.\u00a0<\/strong><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Clarivate U.S.\u00a0market\u00a0access experts\u00a0discuss on recent mergers,\u00a0cause of these mergers\u00a0and their impact\u00a0on the\u00a0healthcare\u00a0system. Read more.\u00a0 Changes in the\u00a0U.S.\u00a0healthcare industry, many of which were prompted by the pandemic, are driving consolidations to&#8230;<\/p>\n","protected":false},"author":8,"featured_media":266550,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_links_to":"","_links_to_type":0,"footnotes":""},"categories":[19,21,23],"tags":[280,118,90],"class_list":["post-147103","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-biopharma","category-life-sciences-healthcare","category-medtech","tag-covid-19","tag-digital-health","tag-market-access","clarivate-product-biopharma","clarivate-product-medtech"],"acf":[],"lang":"en","translations":{"en":147103},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"pll_sync_post":[],"_links":{"self":[{"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/posts\/147103","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/comments?post=147103"}],"version-history":[{"count":1,"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/posts\/147103\/revisions"}],"predecessor-version":[{"id":266248,"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/posts\/147103\/revisions\/266248"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/media\/266550"}],"wp:attachment":[{"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/media?parent=147103"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/categories?post=147103"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/tags?post=147103"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}