Wednesday, 16 January 2019
BREAKING NEWS

Unlikely Bedfellows

The mergers, affiliations, and collaborations have taken a new turn, but it’s not the traditional mergers of health plans with other health plans and provider organizations with other provider organizations. Rather, we’re seeing the “value chain” of health and human services start to morph with unusual combinations in both mergers and collaborations (see The Shifting Health & Human Service Value Chain – The Strategic Earthquake and The Shifting Health & Human Service Value Chain: Strategies & Options To Address The Current Market Challenges for more on the value chain).

The start of this wave was the interesting (and almost approved) proposed merger of Aetna and CVS (see The Merger Of Retail With Health Plans-Strategy, Please)—combining an insurance company with a pharmacy/retail health care organization. And, we had the proposed merger of Cigna and Express Scripts (see Cigna To Acquire Express Scripts For $52 Billion). What are some other interesting collaborations hitting the market?

Provider Organizations & Health Plans

Mayo Clinic & Medica—Mayo Clinic announced earlier this month that it is creating health insurance products to network with provider organizations, starting with Minnesota-based health insurer Medica. Medica will administer the health plans and support consumer engagement and service for the products (see Mayo Clinic To Launch Health Plans With Minnesota Insurer).

Optum & DaVita Medical Group—UnitedHealth Group has continued to buy primary care clinics, including the late 2017 announcement that it had signed an agreement to purchase DaVita Medical Group for $4.9 billion (see DaVita Will Become Part Of Optum’s OptumCare Divisions Which Works With Over 80 Health Plans).

Optum & Reliant Medical Group—Earlier this year, UnitedHealth also acquired Reliant Medical Group for $28 million. Optum has invested an additional $186 million for facilities and care restructuring (see Reliant Medical Acquired By Optum For $28M). (And Optum is now the largest employer of primary care physicians in the U.S., see With 8k More Physicians Than Kaiser, Optum Is ‘Scaring The Crap Out Of Hospitals’.)

Humana & Conviva Physician Group—In February, Humana announced that it will launch a new brand, called “Conviva”, for its health clinics and related physician practices. Conviva Physician Group is designed as a management service organization (MSO), and will provide clinical care to more than 250,000 consumers (see Humana Launches New ‘Conviva’ Brand For Its Health Clinics & Physician Practices).

USHL & Together Health Network—Together Health Network (THN), a subsidiary of St. Louis-based Ascension Health, bought U.S. Health and Life Insurance Company (USHL) in 2015, with the programs initial offering announced in 2017 as self-funded coverage for small to midsize employers marketed under the name SafeGuard® THN (see Ascension Health Subsidiary, Together Health Network, To Acquire Michigan-Based Insurer).

Provider Organizations & Pharma Companies

Civica Rx—A group of hospital owners, including Ascension, Mayo Clinic, and SSM Health, announced that they have launched non-profit generic drug company Civica Rx. Civica Rx includes 300 hospitals that will focus on establishing price transparency and access stability for 14 generic drugs (see Hospital Groups Launch Own Company To Make Generic Drugs).

Geisinger & Medacta International—Earlier this year, Geisinger announced plans to expand its ProvenCare Total Hip program with Medacta International, via a pilot that will cover consumers’ lifetime costs of any subsequent hip replacement surgery. Medacta International is the hip replacement device vendor (see Geisinger Launches ‘Guaranteed For Life’ Hip Replacement Pilot Program Through Partnership With Medacta).

Geisinger & Merck—Geisinger Health System (Geisinger) and pharmaceutical company Merck announced they are releasing two new EHR embedded apps for improved medication management and care coordination (see Geisinger & Merck Unveil EHR-Embedded Apps For Medication Management, Care Coordination). While both apps gather data from multiple EHR platforms, the Family Caregiver Application creates two-way communication between clinical professionals and consumers, and the MedTrue Application collects information from different data sources to bolster medication adherence and reconciliation.

Health Plans & Pharma Companies

Magellan & Otsuka—Magellan Health and Otsuka America Pharmaceutical, Inc. (Otsuka) announced that they will collaborate to bring the ABILIFY MYCITE® drug system to the United States. The ABILIFY MYCITE® system is a drug-device combination that is approved by the U.S. Food and Drug Administration (FDA). ABILIFY MYCITE® is approved for the treatment of schizophrenia, acute treatment of manic and mixed episodes associated with bipolar I disorder, and for use as an add-on treatment for depression in adults (see Otsuka Collaborates With Magellan Health To Launch ABILIFY MYCITE®).

UPMC & Alkermes—UPMC Health Plan (UPMC) recently announced it has joined in a value-based contract with pharmaceutical company Alkermes for Vivitrol, an injected drug that helps to block opioid cravings. The contract was led by the Center for Value-Based Pharmacy Initiatives, a non-profit group that is part of UPMC’s Insurance Services Division (see UPMC Health Plan Announces Agreement For Vivitrol).

Walgreens & kaléo—Walgreens and pharmaceutical company kaléo are collaborating to improve access to epinephrine auto-injectors by making them available at Walgreens locations (see AAFA Applauds Partnership Increasing Epinephrine Access).

Harvard Pilgrim & Eli Lily—Harvard Pilgrim health plan has twelve different outcomes-based contracts in place for medications. In one, Harvard Pilgrim pays Eli Lilly a lower price for its Type 2 diabetes drug Trulicity if consumers do better on competing diabetes drugs (see Value-Based Contracts Key To Solving U.S. Drug Pricing ‘Crisis’).

Highmark & AstraZeneca—In April, Highmark health plan announced a partnership with AstraZeneca to monitor outcomes of health plan beneficiaries who are taking asthma medication, Symbicort. If beneficiary outcomes are not as expected, AstraZeneca will provide the health plans with savings (see Highmark Health strikes outcomes-based contract for asthma drug).

Pharma, Health Plan & Tech Initiatives

Novartis & Pear Therapeutics—PEAR Therapeutics announced a collaboration with Novartis to pursue marketing approval for PEAR’s existing THRIVE digital therapeutic focused on schizophrenia. The THRIVE application is intended for use in conjunction with antipsychotic medications. The application provides real-time consumer monitoring and support, and real-time interventions targeting positive symptoms of schizophrenia including hallucinations and delusions (see PEAR Therapeutics & Novartis Collaborate On Digital Therapeutic For Schizophrenia).

Takeda, Lundbeck, & Advocate Health Care—Takeda and Lundbeck will explore the effectiveness of the Advocate Pathway mobile app to improve engagement between consumers with major depressive disorder (MDD) and clinical professional. The app will assess the consumer’s antidepressant therapy (see Takeda, Lundbeck, Advocate Health Care collaborate on depression app study).

Beacon Health & MDLIVE—Beacon Health Options and MDLIVE Inc. announced that they entered a partnership intended to augment Beacon’s behavioral health programs and network of professionals through MDLIVE’s telehealth platform for licensed counselors, psychologists, and psychiatrists (see Beacon Health Options Adds MDLIVE Behavioral Health Professionals To Its Provider Network).

Amazon & PillPack—In June 2018, Amazon acquired PillPack, a prescription drug distribution company, setting them up for an entrance into the pharmaceutical market (see Amazon acquires online pharmacy PillPack in move into health care).

These are examples of a trend in the field. Specific to the pharmaceutical field, over a 10-year period from 2005 to 2015 there were 9,000 new biopharma R&D collaborations (see Collaboration As A Key To Success In Pharmaceutical R&D)—including new treatment program designs and work with provider organizations to differentiate the treatments against the traditional standards of care. The path forward means more collaboration—with scientific partners, with technology partners, and with clinical partners (see Innovating To Survive, Collaborating To Thrive: 2017 Pharmaceutical R&D Leader Survey).

And, these new ventures are likely to have a competitive edge by focusing on “value” (see Value Comes To Pharmaceuticals, Devices & Digital Treatment and Hidden Behavioral Health Opportunities In Value-Based Reimbursement). Last year, PwC reported that 25% of pharmaceutical companies have used value-based contracts (see Launching Into Value: Pharma’s Quest To Align Drug Prices With Outcomes).

For more, stay tuned from our live coverage on Friday, September 29 from The 2018 OPEN MINDS Mergers, Acquisitions, & Affiliations Summit: Best Practices For Non-Profit Health & Human Service Organizations – A Centerstone & OPEN MINDS Collaboration. @openmindscircle will be providing live social media coverage of this year’s event. To join the discussion on Twitter, use this year’s official hashtag: #OMLeadership. And be sure to stop by our Facebook page on Friday, starting at 8:00 am, for live coverage.

And for even more, check out the March 2018 edition of the OPEN MINDS management newsletter explores how partnerships, mergers, acquisitions, and affiliations are shaping the complex consumer market (see Mergers & Acquisitions The Focus Of The March OPEN MINDS Management Newsletter: Features Executive Perspectives From Centerstone, Franklin Management Resources & Oaks Integrated Care Executives).

Source: https://www.openminds.com/market-intelligence/executive-briefings/unlikely-bedfellows/

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