Specialist
Former VP, medicare clinical operations at Anthem Inc
Agenda
- Recent trends and developments in the US managed care market
- Impacts of Inflation Reduction Act on prescription access and Affordable Care Act subsidies
- Care utilisation and cost control dynamics across Medicare, Medicaid and commercial segments
- Elevance’s growth opportunities, touching on strategies around services segment and increasing its dual-eligible footprint
Questions
1.
What major trends and drivers have you been following in the US managed care space over the past 12 months or so that might better inform our discussion on Elevance Health, formerly Anthem?
2.
What are your thoughts on the Inflation Reduction Act’s impact on Elevance, particularly the continuation of the Affordable Care Act subsidies? How much of a tailwind does this present for the company?
3.
Could you outline some scenario implications around the Medicaid redetermination timelines, perhaps the ramifications of multiple extensions vs a discontinuation for Elevance’s eligible membership pool? It appears likely that the Biden administration would continue the public health emergency, especially ahead of the 2022 mid-terms.
4.
How tangible or muted an impact is the current inflationary environment having on Elevance’s core managed care business? How is the company thinking about pricing in inflation for the upcoming selling season both on the cost of care side, but also premiums?
5.
What do you think were the primary drivers of higher medical costs in the commercial segment in Q2 2022, and how much should we read into inflated commercial costs of care longer term?
6.
What do you think Elevance is doing differently to help reduce costs on Medicaid populations? Medicaid costs came in lower than anticipated last quarter. How might the company be differentiated in its patient engagement capabilities or even leveraging social determinants of health for historically unhealthier and harder to reach populations?
7.
Could you expand on Elevance’s digital strategy to become more engaged with its member base across segments? How is the company utilising technology to interact with members to improve access, customer satisfaction and risk profiles?
8.
What tweaks can Elevance make to its pricing or overall cost-containment strategy to better account for some of the uncertainty we may see from the macroeconomic environment, lingering pandemic headwinds or other factors?
9.
How do you anticipate the Inflation Reduction Act will impact patients’ access to prescription drugs? Could there be any impact on IngenioRx’s profitability?
10.
What are your thoughts on the Elevance’s contracts with value-based primary care physician groups in the Medicare Advantage segment? Any particular value-based healthcare primary care physician groups that you’ve worked with would also be helpful.
11.
Could you further unpack Elevance’s value-based Medicare risk contracts with ACOs [accountable care organisations] such as ChenMed? What are your thoughts on the company’s ability to be successful in some of these arrangements?
12.
How is Anthem thinking about managing the higher chronic care management costs in areas such as oncology, cardiology and musculoskeletal? Does the company do it in-house or does it outsource to vendors such as New Century?
13.
How do you assess Elevance’s historical approach to the annual enrolment period? What could the company do differently to better execute on adding plan members in Medicare Advantage, perhaps thinking about the benefit mix and/or pricing?
14.
How much incremental revenue can be unlocked through government programmes for Elevance over the next three years? Is USD 33bn across Medicare and Medicaid by the end of 2025 a reasonable metric? If so, why?
15.
What are your thoughts on Elevance’s MyNexus product and the company’s overall strategy to increase its presence in post-acute care settings and the home? What is the greater strategic vision there?
16.
What has been Elevance’s approach to converting employer clients to value-based arrangements? How are you gauging willingness of employers to flip ASO [administrative services-only] plans to outcomes-based?
17.
What acquisitive appetite do you think Elevance will have over the next 9-12 months or so? Where might the company look to facilitate inorganic growth?
18.
How do you assess Elevance’s efforts to continue to grow its dual-eligible footprint? What are the main considerations there?
19.
Is there anything that we haven’t touched on that you might like to highlight or might be underappreciated about Elevance, formerly Anthem?
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