The nation's largest health insurers are no longer just insurers — nearly all have restructured and grown into health services giants capable of paying for care and providing it too.
UnitedHealth Group operates health benefits under UnitedHealthcare and medical services through Optum. Anthem rebranded to Elevance Health in 2022 and launched Carelon, its healthcare services brand. In 2023, Humana split between an insurance segment and healthcare services segment, CenterWell, and the Cigna Group was formed to include insurer Cigna Healthcare and health services arm Evernorth.
Being independent companies, the many Blue Cross Blue Shield plans have responded to the consolidation trend in different ways. This year, some have launched their own primary care subsidiaries, others have turned to mergers and acquisitions with other Blue Cross plans, while some have partnered with retail disruptors such as Amazon and Mark Cuban's Cost Plus Drugs.
To aid in their own transformations, several of the largest payers have also partnered with nontraditional organizations quickly pushing their way into healthcare. This year, UnitedHealthcare and Walmart launched a co-branded Medicare Advantage plan. The 10-year collaboration began at 15 Walmart Health centers in Florida and Georgia, which are enabled by Optum's analytics and decision support tools.
"What we don't know is where they're all going," Robert Pearl, MD, a professor at Stanford (Calif.) University and former CEO of Kaiser's Permanente Medical Group, told Becker's.
"But I look at what's happening. Through massive acquisitions, [these companies] each now have a pharmacy, they have a delivery arm, they have insurers, and they have home health services. Why would they do all of these things? I think it's because they're trying to replace all of the current healthcare system.
"If I'm an insurer today that is not affiliated with any of the retail giants or other big groups, I'd be very worried they're going to take my patients away and drive me out of existence."