Anthem to become largest US health insurer after $54B Cigna acquisition
Another pair of health insurance giants are about to become one. Anthem (ANTM) has agreed to acquire rival Cigna (CI) in a $54.2 billion deal, creating the health insurance industry’s largest company by enrollment.
Expected to close in the second half of 2016, if the deal passes state regulatory approvals and other requirements, the merged insurer would cover 53 million members.
Changing the health insurance industry
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Earlier this month, Aetna struck a deal to buy Humana (HUM) for $37 billion, according to CNN Money, and UnitedHealth just completed its own $12.8 billion acquisition of Catamaran, a pharmacy-benefits manager and prescription provider.
Health officials are concerned that the mergers will place too much power in just a handful of insurance companies, and there are also worries that costs will go up because of less competition.
"These mergers must be seriously scrutinized to ensure that consumers and healthcare providers are protected from mega-insurer market power abuse,” Sen. Richard Blumenthal (D-Conn.) told the LA Times.
“Anthem already dominates the employer-based insurance markets in 10 of the 14 states where it owns Blue Cross Blue Shield plans, and the addition of Cigna leaves employers in those states with even less choice than they have now,” Paula Wade, an analyst at Decision Resources Group in Burlington, Mass., added.
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But the health insurers are defending their move.
In a conference call on Friday, July 24, with analysts, Joseph Swedish, Anthem’s chief executive, said, “We believe this is the best transaction for both companies. We will create a company that will transform health care and benefits for consumers."
Looking at the Affordable Care Act
The ACA has put pressure on health insurers to cut costs and improve care coordination, which has led analysts to believe is the reason behind the rise of mergers and acquisitions. But the act has also pushed for more insurance competition, particularly in the public exchange markets.
“The purpose of Obamacare was to provide a breadth of competition to health care markets in which there was too much concentration,” David Balto, an antitrust attorney who formerly worked for the Department of Justice and the Federal Trade Commission told Modern Healthcare. “Permitting these mergers would be a giant step backwards.”
Because of the sheer size of the companies, state and federal antitrust regulators will likely examine the deals closely. Joshua Raskin, an analyst at Barclays Capital, told Modern Healthcare he believes the Anthem and Aetna deals will ultimately go through, since all parties involved have legal advisers on board who likely have anticipated such questions. However, Anthem and Aetna may have to divest some of their health plans to maintain local competition, especially in the private Medicare Advantage market, Raskin said.
Details of the merger
Anthem is expected to pay $188 a share for Cigna. About 55 percent of the deal will be financed through cash and the remaining will be funded by shares of Anthem’s stock.
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About 15 percent of revenue will come from Medicaid and Medicare members, and Anthem will also be gaining Cigna's growing international business. If Anthem or Cigna aborts the deal, a $2 billion break-up fee would go into effect. Shareholders must approve the deal as well.
Swedish will continue to serve as chairman and chief executive. Cigna CEO David Cordani will be his No. 2 as president and chief operating officer. Cordani will also join the Anthem board along with four other Cigna directors.
Dexcom: changing the lives of people with type 1 diabetes
It is estimated that 9.3% of adults around the world are living with type 1 diabetes, which amounts to a total of 463 million people. A further 1.1 million children and adolescents under the age of 20 are living with the condition.
Unlike the more prevalent type 2 diabetes, where the body still produces insulin and symptoms develop slowly, people with type 1 diabetes need regular insulin injections or pumps, and must monitor their sugar levels frequently.
In recent years a number of remote glucose monitoring systems have become available that patients can use at home. These work with a sensor, usually placed under the skin, that measures glucose levels every few minutes. This information is then transmitted wirelessly to a device like a smartphone or tablet, which can then be shared with their clinician.
British actress Nina Wadia's son Aidan, 14, has type 1 diabetes, and has been managing his condition using Dexcom, a glucose monitoring system used by patients all over the world. Here Wadia explains how Dexcom has improved their lives.
As a parent of someone with type 1 diabetes, what is your day-to-day life like?
Being able to take a breath, think and pivot constantly without getting frustrated becomes an essential mindset because sometimes it feels like each day is determined to be different from the day before. Whatever worked yesterday is going to misfire today.
Which areas of yours and Aidan’s life are most impacted by diabetes?
The one thing that you have to fight hard to reclaim is spontaneity, especially when it comes to food and exercise. It’s only when this is taken do you realise how essential each one is. You can be flexible and there are no real limits, but only in the sense that a great athlete can be flexible without limits because they’ve trained super hard to be that way. So we’ve all had to become athletes when it comes to being spontaneous.
How has Dexcom helped you and Aidan?
Dexcom has brought future science fiction to real life today. The continuous glucose monitoring system is tiny, sits discreetly on his body and gives him a ten-day breather between sensor changes, so it's goodbye finger-pricking seven times daily.
Dexcom is totally active at a grass roots level and for Diabetes Awareness has pledged to donate £2,000 if #DexcomDiabetesStories and/or #DexcomWarriorStories is shared 200 times! I’ll be sharing more on social media and would love to hear how other families are winning their fights.
Maybe most importantly Dexcom is trying to introduce a reimbursement programme for type 1 diabetes patients which will give greater access to modern, life changing hi-tech. I want to spread the word on the importance of accessing it through this campaign.
If you compared your life today with how it was before Aidan was using Dexcom, what has changed?
It's always working, which lets him take his mind off diabetes for longer stretches. It also lets me get off his back. We both receive alerts so I no longer have to pester him by asking him what his number is, and especially importantly, I don’t have to wake him at night to prick his finger if I’m worried. Dexcom gave us back our sleep!