Keeping an eye on marketplace changes

• Health care merger and acquisition activity had a record-breaking first quarter. Health insurer Cigna's proposed purchase of Express Scripts for $67 billion comes just three months after Cigna rival Aetna agreed to be acquired by drugstore chain CVS for $69 billion. Insurance companies have been forced to find alternative ways to adapt and grow in a changing health care industry after the Justice Department blocked two massive deals involving four of the five biggest health insurers on antitrust grounds a year ago.
• Insurers are branching out. UnitedHealth Group's Optum unit acquired DaVita Medical Group, showing that the national company is seriously expanding beyond insurance, including a deal to acquire the Advisory Board's consulting business for $1.3 billion.
• Health system mergers are at an all-time high. Health systems say the deals are part of a future where hospitals and clinics are better able to provide efficient care across a broad population of patients. But there are worries that bigger systems may lead to continued rising prices and high costs. A new level of complexity emerged through the Walmart-Humana deal. This is a strong sign that the health care industry is rapidly merging with the retail world.
• Major disruptors lead to talk about innovation and concern. The announcement of the partnership between Amazon, Berkshire Hathaway and JPMorgan has been cited as a potentially necessary disruptor, but is also said to be solely an effort to defend the health care benefits of their million or so employees, rather than the 156 million people who receive employer-based coverage. Time will tell.

Deb Krause serves as vice president for the Minnesota Health Action Group, a coalition of health care purchasers dedicated to improving health care quality and access through collaboration, innovation, engagement and leadership. Prior to The Action Group, Deb held leadership positions at Mercer and UnitedHealth Group. She has been a volunteer leader with nonprofit organizations for 25 years and is the chair of the American Cancer Society's Minnesota State/Dakota Area Leadership Board.