Anthem says that all health insurers’ core product “is access to a medical network at discounted rates,” and that antitrust regulators are wrong to assume that a larger Anthem won’t be able to drive down costs and preserve collaborations with physicians.
Anthem, which was blocked by a federal judge from buying Bloomfield-based Cigna in February, is appealing that ruling. It filed its reply to the antitrust division’s case on
In the original case, Anthem argued it should be allowed to buy Cigna because the combined company would be reduce health care spending for its customers by $2.4 billion. The judge said those savings were speculative; wouldn’t necessarily flow to consumers; and, if implemented, could hurt providers.
In the latest brief, Anthem said although the Department of Justice praises Cigna for its innovative agreements with physicians, it’s Anthem that has more value-based contracts. These sort of agreements are designed to shift away from paying doctors for every service, and reward them instead for improving the health of the insured population which should reduce the amount of health care spending overall.
“Anthem is already more successful at lowering utilization than Cigna,” the company wrote.
And, it said, testimony during the trial showed that Anthem’s increased bargaining power against doctors and hospitals is not a violation of antitrust law, because those lower prices paid to providers would not result in providers working less.
The Department of Justice has argued that even if the appellate court overturns the original judge’s finding, the case should be returned to her. Anthem said in its reply that remanding the case is unnecessary, since the factual record is exhaustive.
Getting the case settled quickly is critical for Anthem, because Cigna no longer wants to be part of the merger. After April 30, if the deal has not received all the regulatory approvals, Cigna can walk away and will argue Anthem owes the company $1.85 billion because the deal failed.
Date: March 20, 2017