Could The Blues Build Their Own Optum?

I’ve suggested this to a few people in the Blues community, but the recent projections from United Health Group about the growth in their Optum business unit compared to the rest of their business got me thinking about it again.  

If you think about Optum, they were basically composed of Ingenix (data and consulting), Prescription Solutions (PBM), and Optum which included utilization management, disease management, wellness, case management and many other services.  

So, if we look at the Blues today, they have several investments that could be used to create an Optum competitor.

• They have Blue Health Intelligence which consolidates data and could provide data and insight and build predictive algorithms.
• They have Prime Therapeutics as a PBM.
• If you then look at Sandbox Industries which is one investment arm, they have several investments that could be relevant:
  • Bloom Health as a defined contribution company (like Optum Bank).
  • Cara Health which provides care management solutions for chronic disease.  
  • Lumeris which offers an ACO solution.
  • Change Healthcare which provides a transparency solution.  
  • ZeOmega which offers a care platform.

If you pulled some of the services back out of the Blues that they’ve insourced over the past few years from companies like Healthways, they would have all the technology and services that Optum has.  They would need a few Centers of Excellence models which I don’t know that they have, but if this is the growth engine for the healthcare industry, there seems to be some great opportunities here.