Anthem CEO Breaks Down myNEXUS Acquisition, Touts At-Home Care Capabilities

27 . 07 . 2021

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Anthem Inc. (NYSE: ANTM) continues to tout its positioning when it comes to home-based care.

The Indianapolis-based insurer acquired myNEXUS — a convener that manages home-based care for payers — earlier this year. Anthem’s focus on how that acquisition improves its overall network since then reflects its home-based commitments.

“We closed on the acquisition of myNEXUS during the second quarter, advancing our strategy to grow and deepen Anthem’s capabilities in Medicare Advantage,” Gail Boudreaux, the CEO of Anthem, said on the company’s Q2 earnings call last week.

On its end, the Brentwood, Tennessee-based myNEXUS is a tech-enabled organization that optimizes home health for over two million Medicare Advantage (MA) members in 20 states. Close to half of those members were already a part of the Anthem network as well, according to the company.

“MyNEXUS improves outcomes by facilitating timely, personalized care for our members in the comfort of their homes, leading to improved continuity of care and reduced hospital admissions, readmissions and ER visits,” Boudreaux said. “In addition to supporting future growth in Medicare Advantage, myNEXUS furthers our diversified business group’s strategy to deliver on its risk contracts to the expansion of home-based care.”

Anthem’s operating revenue for the quarter was $33.3 billion, a 14.1% year-over-year increase from the $29.2 billion it brought in Q2 2020.

Its medical enrollment also increased by 1.9 million lives year over year to 44.3 million members, a 4.4% increase.

“This one hits both parts of our strategy,” Boudreaux said. “Going to the home, virtual and value-based care — those are all of those are critical elements of our cost-of-care strategy. And so having a strong in-home offering, I think, is a really important part, particularly for the senior population.”

Anthem’s in-home strategy is not new. In fact, the insurer has been invested in home-based care capabilities for some time.

In 2018, it acquired the community-based palliative care provider Aspire Health. It has also formed relationships with innovative at-home care organizations such as the senior companionship company Papa and the home-based primary care provider Heal.

Anthem — and a number of its affiliated health plans — additionally was an early adopter of the U.S. Centers for Medicare & Medicaid Services’ (CMS) home-based care-related supplemental benefits for MA plans.

And as it continues to expand home-based care offerings to its members, it’s also trying to gain easier access to the home through virtual offerings.

“We’re starting with, really, our deep data insights, and we’re connecting that with our care provider network, trying to give them the best information across every point in time,” Boudreaux said. “And then we’re using that to enable our value-based care providers, … and virtual is a component of it. And not only virtual, but also at-home care. They all come together.”

Especially over the last year, Anthem has done significant outreach to its members to make sure their non-medical-related needs aren’t going by the wayside.

A major part of that has been enacting those virtual and at-home visits.

“We’re really meeting members where they are and how they feel most comfortable engaging with their care providers,” Felicia Norwood, Anthem’s EVP of government business, said on the earnings call. “Based on our analytics, we feel very good about where we are, and believe that we are on track to help our members’ health risks reflected in our 2020 payments at levels that are similar to 2019.”