UnitedHealth to Buy Equian & Foray into Healthcare Payments


2019-06-28 10:30:00 Zacks


UnitedHealth Group, Inc. UNH, the leading U.S. health insurer, might buy the healthcare payments company Equian for nearly $3.2 billion, per multiple sources. Equian delivers payment integrity solutions through proprietary content, enabling technology and highly responsive customer service. The company analyzes healthcare and insurance data to ensure that payments are fair, accurate, and paid by the correct party—resulting in billions of dollars in savings. This buyout will allow UnitedHealth to add a new niche business to its health services segment, Optum, which deals in health management and engagement, health financial services, health IT, benefit operations, care operations and pharmacy care services. Over the years, Optum has grown to contribute an increasing proportion of total revenues. UnitedHealth anticipates huge growth opportunity in the healthcare payments space, which is still dominated by manual functions leading to billions of waste in administration, thus calling for an urgent need of an overhaul. The digital age has brought new spending habits for consumers, giving rise to the on-demand economy and overall growth in eCommerce spending. But healthcare has lagged in its adoption of technological advances of the digital age, thus causing consumer payments experience to suffer. Although payment responsibility has increased dramatically in the recent years, healthcare organizations have continued to communicate with consumers, as they did half a century ago, through mailed paper statements. The content and layout of those statements have not changed much either. To put this into perspective, nearly 90% of providers leverage paper and manual processes for collections, 53% of payers still deliver checks to providers and 93% of consumers were surprised by a medical bill in 2018. The opportunity in this space has come to the notice of players outside the healthcare industry as well. An example of this is the recent agreement by J.P. Morgan Chase & Co. JPM  to buy Philadelphia based InstaMed, a healthcare payment processor. Equian handles nearly $500 billion in healthcare payments annually for nine out of the 10 healthcare companies. It would allow UnitedHealth to foray into the expanding healthcare payments industry, whose growth is directly linked to the increasing health spending in the United States. The Centre for Medicaid and Medicare Services projects healthcare spending in the United States to grow at an average rate of 5.5% annually to $6 trillion by 2027. Alongside its proprietary use of Equian payments systems, UnitedHealth can also offer payment services to other insurers as the former currently serves almost 90% of the healthcare companies. UnitedHealth will also be able to serve Equian’s clients, which are insurers outside the healthcare space. UnitedHealth has been a bellwether in the industry, staying proactive in the face of continuous challenges and changes that are imposed from regulations. Now that the Trump administration has signed an executive order to make the contracts pricing between insurers and hospitals open to patients and Bernie Sanders campaign on ‘Medicare-for –All’ proposal, to reform Healthcare, a continuous overhang remains on the health insurance business. In order to decrease its dependency on this heavily regulated business and to diverse its revenue sources from less or non-regulated business like Optum, UnitedHealth has made several acquisitions over the years in this segment. The Equian deal also falls in the same line. Year to date, the stock is down 2.3%, compared with the industry’s rise of 0.85%.
美国主要的医疗保险公司联合健康集团( UnitedHealth Group , Inc .)可能会以近32亿美元的价格收购医疗支付公司 Equian 。 Equian 通过专有内容、支持技术和高度响应的客户服务提供支付完整性解决方案。该公司分析医疗和保险数据,以确保付款公平、准确,并由正确的一方支付,从而节省数十亿美元。 此次收购将使 UnitedHealth 在其医疗服务细分市场 Optum 中增加一个新的细分业务, Optum 负责健康管理和参与、医疗金融服务、医疗 IT 、福利运营、护理运营和药房护理服务。多年来, Optum 在总收入中所占比例不断增加。 联合健康预计在医疗支付领域将出现巨大的增长机会,而医疗支付领域仍然由人工功能主导,导致数十亿的行政浪费,因此迫切需要进行改革。 数字时代给消费者带来了新的消费习惯,带来了按需经济和电子商务消费的整体增长。但医疗保健在数字时代的技术进步上滞后,从而导致消费者支付体验受损。 尽管近年来支付责任急剧增加,但医疗保健组织继续与消费者沟通,就像半个世纪前他们通过邮寄的纸张声明。这些声明的内容和布局也没有太大变化。 为了更好地理解这一点,近90%的供应商利用纸质和手工流程进行托收,53%的付款人仍在向供应商提供支票,93%的消费者对2018年的医疗账单感到惊讶。 这个领域的机会也引起了医疗行业以外的参与者的注意。这方面的一个例子是摩根大通( J.P . Morgan Chase & Co . JPM )最近同意收购总部位于费城的医疗支付处理器 InstaMed 。 Equian 每年为10家医疗保健公司中的9家处理近5000亿美元的医疗支付。这将使联合健康进入不断扩大的医疗支付行业,其增长直接与美国不断增加的医疗支出有关。医疗补助和医疗服务中心预计,到2027年,美国的医疗支出将以年均5.5%的速度增长到6万亿美元。 除了对 Equian 支付系统的专有使用外, UnitedHealth 还可以向其他保险公司提供支付服务,因为前者目前服务于几乎90%的医疗保健公司。联合健康还将能够为 Equian 的客户提供服务, Equian 是医疗保健领域之外的保险公司。 联合健康一直是行业的领头羊,面对法规带来的持续挑战和变化,保持积极主动。既然特朗普政府签署了一项行政命令,让保险公司和医院之间的合同定价向患者开放,同时伯尼•桑德斯( Bernie Sanders )发起了“全民医保”( Medicare-for-All )改革医保的计划,医疗保险业务仍面临持续的问题。 为了减少对这一受到严格监管的业务的依赖,并使其收入来源多样化,从较少或不受监管的业务,如 Optum ,联合健康多年来在这一领域进行了几次收购。Equitan 的交易也同样如此。 今年迄今为止,该股已下跌2.3%,而该行业的涨幅为0.85%。