At an investor conference last week, Aetna Chief Financial Officer Shawn Guertin said the company intends to create a health services division with Humana's assets once their $37 billion deal was closed.
It's a sign that even the largest health insurance companies realize they must do more than just sell health insurance if they want to remain at the top of the food chain in the long term. UnitedHealth Group has embraced this model through its Optum subsidiary.
The country's aging demographic and Humana's Medicare brand made Humana one of the most desirable targets in the market, Guertin said. However, Humana has grown its provider and clinical lines of business.
For instance, Humana controls the country's fourth-largest pharmacy benefit manager. That allows the Louisville, Ky.-based insurer to negotiate prescription drug prices on its own instead of outsourcing. It has also invested in the clinically based Humana At Home division, which helps seniors transition out of the hospital and into their homes.
“This is really one of the most exciting pieces of this longer term,” Guertin said.
Aetna could create its own version of Optum, which is built primarily around clinical consulting, data analytics and drug management. While Humana has the clinical and pharmacy parts, Aetna has the healthcare information technology components.
Diversifying beyond health plans and claims management has proven to be a moneymaker, at least for UnitedHealth. Optum is UnitedHealth's most profitable segment, posting a 6.4% operating margin in the second quarter of this year compared with a 6.1% figure for the insurance division. Optum had a 6.9% margin in fiscal 2014, while UnitedHealthcare tallied a 5.8% figure.
