New Rivals: Integrating Health Benefits to Provide Comprehensive Patient Care

On March 8, 2018, health insurer Cigna agreed to purchase the largest pharmacy benefit manager (PBM) in the United States, Express Scripts, for $52 billion.1 This deal is the latest in a wave of payer consolidations that have the potential to reshape the US healthcare. Payers and PBMs are joining forces to maintain their competitive edge in a constantly shifting environment. The ability to integrate health benefits around the patient to provide comprehensive care begins to align incentives related to medical and pharmacy costs. Recent changes to the Affordable Care Act; threats that Amazon may enter the healthcare market; and the announcement that Amazon, Berkshire Hathaway, and JPMorgan Chase have joined forces to create a new healthcare company have inspired many to look at healthcare differently.