Diplomat Pharmacy, under Pressure, Merges with OptumRx

Diplomat Pharmacy, under Pressure, Merges with OptumRx

In early November, Diplomat Pharmacy, Inc. (NYSE: DPLO) revealed some troubling news. The company reported a net loss of $177.3 million in its third-quarter earnings report, its third in a row, and issued a “going concern” warning. Shares dropped 50% (from $6.20 to $3.10) that morning. Brian Griffin, chairman and CEO of Diplomat, cited industry headwinds pressuring its prescription benefits management (PBM) business, and its failure to renew network participation in their specialty pharmacy network. Diplomat’s PBM segment generated $82 million in Q3:19, compared to $170 million in the same quarter last year. Diplomat Pharmacy’s efforts to expand in the PBM sector... Read More »
Accent Acquired by HMS Holdings Corp.

Accent Acquired by HMS Holdings Corp.

After making a string of digital health deals over the past few years, HMS Holdings Corp. (NASDAQ: HMSY) has now expanded into the managed care sector. In the last week of November, the company announced its acquisition of Accent from Intrado Corporation for $155 million. The target company is a payment accuracy and cost containment business. Accent’s healthcare payer clients include large commercial health plans, Blue Cross and Blue Shield plans, provider-sponsored health plans, Medicare Advantage plans, third-party administrators and self-insured employer groups. Its offerings include comprehensive prospective and retrospective claims accuracy solutions, which incorporate cost avoidance... Read More »

UNH & Optum Expand Their Digital Health Portfolio

Optum, a UnitedHealth Group (NYSE: UNH) company, has acquired another digital health company. The target is Vivify Health, whose mobile, cloud-based platform offers remote care management services such as personalized care plans and biometric data monitoring. The deal was first reported by CNBC. Vivify’s program uses health devices ranging from a wireless weight scale to portable blood pressure cuffs. Remote patient monitoring (RPM) systems offer a great deal of value for providers and payers. They help physicians and doctors stay up to date on a patient’s health without any hospital visits or trips, an they offer an opportunity to take preventative measures if a... Read More »
Molina Healthcare Expands in Upstate New York

Molina Healthcare Expands in Upstate New York

Molina Healthcare (NYSE: MOH) has been off the acquisitions circuit for some time, as management issues were being worked out. The insurer’s last completed deal was announced in April 2016, in fact. That transaction targeted Universal American’s (NYSE: UAM) Total Care Medicaid plan, a prepaid health services plan providing health care coverage to approximately 39,000 members under the Medicaid and Child Health Plus programs in the three upstate New York counties of Cortland, Onondaga and Tompkins. The sale netted Universal American $41.3 million. In mid-October, Molina broke its streak with the acquisition of certain Medicaid assets of YourCare Health Plan, Inc., a... Read More »
Molina Healthcare Expands in Upstate New York

Managed Care Deals for All in 2019

Investors seem unfazed by the Democratic presidential candidates’ debate around the topic of “Medicare for All.” Mergers and acquisitions in the Managed Care sector are flowing quite well this year. Halfway through September, 20 deals have been announced, putting this sector on track to equal or possibly exceed the 25 deals announced in 2018. Over the last decade, annual deal volume in this sector has averaged 20 deals per year. The peak was hit in 2015 with 43 deals, not including the terminated mega-deals between Aetna and Humana (NYSE: HUM) for $37 billion and Anthem (NYSE: ANTM) and Cigna (NYSE: CI) for $54 billion. In June of that year the U.S. Supreme Court ruled... Read More »
Molina Healthcare Expands in Upstate New York

Priority Health Expands Medicaid Network in Michigan

Priority Health, the second-largest health insurer in Michigan, announced it will acquire the state’s oldest health plan, Total Health Care. The target company was founded in 1973 as a membership-owned, not-for-profit with 96,000 members – 53,000 Medicaid HMO and 43,000 individual commercial members through two companies, Total Health Care Inc. and Total Health Care USA Inc. The group also operates more than 2,500 healthcare centers in five counties surrounding the Detroit metropolitan area. This acquisition will give Priority a huge boost to its already 830,000 covered lives in its Medicare, Medicaid, commercial and employer group products. Priority also wanted a larger... Read More »