Health Policy Experts Fear the Worst With Payer Mergers

"WASHINGTON -- Two of the largest names in healthcare insurance are buying out their competition, triggering an investigation by the U.S. Department of Justice (DOJ) and expressions of concern from hospital and physician groups, as well as Congress.

In July, Aetna announced plans to acquire Humana for $37 billion. Just a few weeks later, Anthem revealed it was merging with Cigna in a $48 billion deal.

Critics say merging four of the five biggest insurers in the nation will kill competition, causing premiums to rise, benefits to narrow ,and provider payments to decline.

"Once [these deals are] consummated, there is simply no going back," said Andrew Gurman, MD, president-elect of the American Medical Association, in testimony before the House Judiciary Committee last week.

"You cannot unscramble an egg," said Gurman, who is an orthopedic hand surgeon based in Altoona, Pa.

Proponents of the mergers (namely, industry executives) argued that consolidating these four businesses would reduce administrative costs and expand networks, allowing companies to provide a broader array of products and services. The mergers would also accelerate the transition to value-based care and strengthen healthcare analytics, they said."

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