From the Indianapolis Star this morning comes an interview with the new CEO of Anthem. Really nothing new (about Anthem) in the article and the reporter asked a lot of softball questions. What was new, at least to the Blogmeister, is Anthem’s new buddy-buddy relationship with M-Plan who has apparently decided they cannot compete with Anthem and is giving them a large portion of their business.
Say what you want about the government running a single payor health system, but it appears Anthem is well on their way to providing a private single payor health system, at least in Indiana. As you read the quote from the story below, keep in mind WellPoint, Anthem’s parent company, according to CNN, made almost 57 billion dollars in 2006 (2007 isn’t available yet).
Anthem Blue Cross and Blue Shield of Indiana is big and it’s getting bigger.
The healthinsurer, part of Indianapolis-based industry giant WellPoint, provides health benefits for roughly 2.5 million Hoosiers. Anthem controls about 60 percent of the commercial health insurance market statewide, according to an analysis by the American Medical Association.
Robert Hillman took the helm of that insurance behemoth when he was named president of Anthem Blue Cross and Blue Shield in Indiana last October.
These are busy times at Anthem. The insurer has been working — under an endorsement agreement with M-Plan, a 125,000-member Indianapolis health maintenance organization that is shutting down — to gain new members. Anthem also is helping to run Indiana’s Healthy Indiana Plan, which provides coverage for low-income Hoosiers.
But Anthem also is involved in high-profile disputes with two physician practices over reimbursement rates and frequently is criticized for selling coverage that many say is simply unaffordable.
Hillman talked with The Star last week after his first few months leading Anthem in Indiana. This is an edited transcript of that conversation:
Question: What are your biggest priorities?
Answer: The primary goal is to make sure we fulfill our mission, which is to improve the lives of the people we serve and the health of our community. We’re looking at making sure that we continue to deliver products that provide value to our customers and that we’re participating in programs that are really improving the health and wellness not only of our members but also the community at large.
Q: Given Anthem’s large market share, where do you see the biggest potential for growth?
A: We still think the consumer- directed market is a big market opportunity for us. The other, obviously, is the uninsured market, particularly in the two- to 50- employee market, where you have really an alarming number of employers who are electing not to participate in the private health- care market and are dropping their health-care coverage.
It’s an opportunity to develop products that bring those folks back into the private payer market.
Q: How much business did Anthem capture from M-Plan shutting down its HMO business? Has the transition been smooth?
A: Well over 50 percent (accounting for 75,000 to 80,000 new Anthem members) of that business transitioned over from M-Plan.
The transition went really smoothly because the partnership with M-Plan, once they decided to exit the business, the cooperation on their part in working not only with our sales team but also our operations team, you couldn’t have asked for a better number.
Q: Indiana has roughly 750,000 people who are uninsured. As the state’s largest commercial health insurer, does Anthem share in the blame for the large number of people who find health coverage unaffordable and unattainable?
A: I don’t think there’s any single payer that’s to blame. We’re all operating in the system that we’re operating in, which is the private payer system, which is an employer-based system. No employer is required to offer health insurance, nor is any (insurer) required to offer health insurance.
What I do think we have an obligation to do, and it’s a challenge, is to try to develop products that are affordable and that provide value to employers and their employees so they want to participate in the private-payer system.
We have an obligation to cooperate whenever we can and however we can with government, like we have cooperated with Gov. Daniels and his Healthy Indiana program.