Is UnitedHealth Gearing Up for Reform?

By Jennifer Lubell - April 24, 2012 UnitedHealth Group has been racking up acquisitions of Medicare Advantage (MA) plans, not to mention several contract awards that previously belonged to Blues plans. As one health care observer explains, larger plans like United are seeking to expand their presence nationally, to prepare for whatever happens with health reform. United in particular has been successful in winning several contracts to cover state employees over Blues carriers in Nebraska and Texas, not to mention a military health system contract that TriWest Healthcare Alliance Corp., a coalition of several Western state Blues plans, held for many years. It’s also been busy acquiring several MA-focused plans in Florida, as well as Baltimore MA plan XLHealth Corp. If larger plans are able to control access and gain a large membership base, “they will be well positioned to leverage” reforms in the accountable care and state exchange environments, Deb Mabari, CEO of Cody Consulting Services, Inc., a health care consulting firm in Tampa, Fla., suggests. Even if the Supreme Court ends up striking the entire health reform law, these plans will still be able to maintain a competitive advantage, “as controlling access equals controlling members,” she explains. Blues plans in turn have been responding to United’s actions by trying to block such competitors from gaining access to their provider network, Mabari says. The Nebraska Blues plan in particular is challenging the contract it lost to United by issuing a lawsuit against the state. As recently reported in The AIS Report on Blue Cross and Blue Shield Plans, the Blues plans argue that United’s benefits are limited and would not serve the best interests of customers in their respective states. What do readers think? Are major insurers like United, Humana and others engaging in these acquisitions and going after more contracts to prep for health reform?