Health Plan Weekly

Blue Cross Blue Shield of Michigan and Blue Cross and Blue Shield of Vermont, the largest health insurers in their respective states, have struck an agreement that will see the Vermont Blues plan become a subsidiary of BCBS of Michigan. The nonprofit companies said in a May 1 news release that this deal “is an affiliation, not an acquisition, which means there is no financial exchange between the organizations.”  

The plans’ boards of directors have approved the agreement, which still needs to be approved by state regulators. A BCBS of Michigan spokesperson tells AIS Health that the regulatory process “will take several months to complete.” If the deal closes, the insurers will share technology platforms and other service offerings, among other collaborations.  

Recent weeks have brought both good and bad news for insurtechs, with Bright Health Group, Inc. appointing a new chief financial officer, putting its last health insurance asset up for sale, and disclosing that it’s being sued by a provider group for unpaid claims. Clover Health Investments Corp., meanwhile, revealed that it will outsource its core insurance operations to a technology vendor, cut 10% of its workforce, and settle one of a series of shareholder lawsuits filed against the company.  

Industry observers tell AIS Health, a division of MMIT, that the net effect of those developments isn’t yet clear, but one thing is certain: The Bright and Clover sagas are far from over. 

Due to the early close of its deal to purchase Oak Street Health, CVS Health Corp. when reporting first-quarter 2023 results said it would lower its full-year earnings per share (EPS) estimate from a range of $8.70 to $8.90 down to $8.50 to $8.70. Yet that short-term headwind is a small price to pay for the long-term benefits of the transaction combined with another recently closed deal to buy Signify Health, CEO Karen Lynch said during the company’s May 3 earnings call.  

“These acquisitions significantly advance our value-based strategy by adding primary care, home-based care, and provider enablement capabilities to our platform,” she said. Moreover, “the combination of Signify, Oak Street and CVS Health creates a value-based, person-centered care platform propelled by the powerful connections between our unique capabilities and assets. This will enable us to drive better patient experience and health outcomes while delivering on our long-term financial goals.” 

Kaiser Permanente unveiled plans to acquire Geisinger Health and make it the first member of a new value-based nonprofit health organization called Risant Health, if the deal gains regulatory approval.

Kaiser Permanente’s health insurance products cover more than 11 million people in eight states and the District of Columbia, according to AIS’s Directory of Health Plans. Combined, Kaiser’s seven regional managed care plans form the largest provider-sponsored insurer, enrolling 28.1% of all provider-sponsored lives. It is the largest insurer in the commercial risk market, with over 9 million members. It also ranks as the fifth-largest Medicare Advantage health plan in the nation.