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California’s Two-Headed Regulator Splits On Mega-Mergers as DOJ Pressure Builds
By John Dubas
From Health Plan Week on Monday, June 27, 2016
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Take for instance large employers, who for all the talk of health plans combining remain more focused on consolidation on the other side of the payer-provider spectrum, according to Steve Wojcik, vice president, public policy, National Business Group on Health (NBGH). He tells HPW “our members have expressed more concern about the rapid consolidation among the providers with hospitals and physician groups. And that has probably flown under the radar and doesn’t get as much attention because that affects local markets and is not on the national scale like the insurance mergers.”

As for the pending insurer deals, NBGH wants to decipher what the impact on employer plans would be in terms of leverage in pricing and delivering improvements to coverage and care, Wojcik says.

With Aetna-Humana, there is not as much concern since Humana has no major presence in the self-funded market. “With respect to Cigna and Anthem, they are both big players in the employer space but my understanding is they don’t have a lot of overlap in terms of states they are in. And the combination would create more of a national reach that is a potential good thing for employers operating in many states,” he says. “By and large, our view is that scale for the sake of scale might end up just raising costs and doesn’t help employer plans. But scale that is used as leverage to accelerate the movement to value-based purchasing, better care coordination and population health management is what is needed. And to the extent that an insurance merger enables that would be helpful to employers.”