Insurers Eye Medicare Advantage Acquisitions

Margaret Dick Tocknell, for HealthLeaders Media , September 2, 2011

WellPoint and CareMore Health Group

The giant WellPoint gained about 54,000 Medicare Advantage members as well as access to healthcare clinics that cater to that population when it completed on August 22nd its acquisition of CareMore Health Group.

The Cerritos, Calif.-based Medicare Advantage plan has members in Arizona, California and Nevada where it also operates 26 clinics staffed with physicians and other healthcare professionals. Most of CareMore's members have chronic conditions that require the care of several specialists.

The insurer, which has about 550,000 Medicare Advantage members, had been looking for a way to jumpstart its participation in the market. During a February conference call with investors, CEO Angela Braly acknowledged the insurer's struggles and said the company would probably make an acquisition to grow that market segment. "We haven't captured the market share that we could there."

WellPoint estimates that every year until 2030, about one million baby boomers will become eligible for Medicare in the 14 states where it offers insurance plans.

While CareMore adds some members, James said the acquisition of the healthcare clinics that will have the most impact. The addition of CareMore provides WellPoint with a model for delivering care coordination and intensive treatment of chronic conditions. WellPoint plans to expand the clinic model to additional CareMore and WellPoint markets.

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