Anthem to buy at-home provider, benefits coordinator myNEXUS


Anthem on Wednesday said it will acquire home health benefits manager myNEXUS, marking the payer’s entrance into the provider business aimed at cutting healthcare costs and creating better outcomes for its 2.3 million Medicare Advantage members.

The Indianapolis-based insurer, which operates Blue Cross and Blue Shield plans in 14 states, will pay an undisclosed sum to buy the Brentwood, Tenn.-based management company. The seven-year-old startup automates home visit authorizations and offers analytics services to insurers, employs a staff of more than 250 clinicians and boasts a nationwide network of at-home providers and nursing agencies. The startup said it currently provides home care support to 1.7 million Medicare Advantage members across 20 states. myNEXUS has so far raised $31.7 million in funding, according to Crunchbase.

“Providing timely care for members in their homes allows for both excellent personalized care as well as the comfort of being in preferred environments,” Dr. Prakash Patel, president of Anthem’s Diversified Business Group, said in a statement. “Bringing the right level of whole person care into the home has been demonstrated to improve outcomes, reduce readmissions and improve members’ and their family’s experience of wellbeing.”

myNEXUS will join Anthem’s diversified business group, which includes its other non-insurance assets like the CareMore medical group, Aspire Health palliative care provider and Beacon behavioral health services. Anthem has previously named this business line as a growth area.

During the company’s investor’s day in early March, Anthem said its diversified business group currently manages 7% of its medical spend and, by 2025, expects it to oversee 25% of its medical costs. Twenty-nine of the 35 non-Anthem Blues plans use at least one of the products from this business line, including Sharecare, which Anthem invested in February. At the time, Anthem said the Sharecare would build out its digital engagement and personalization strategy through more robust AI capabilities. Its acquisition of myNEXUS, which it expects to close in the second quarter, will further strengthen its tech offering for its growing number of Medicare Advantage enrollees, Cantor Fitzgerald analyst Steven Halper wrote in a research note on Wednesday.

In 2021, Anthem expects to grow Medicare Advantage membership by double-digits, with Blues members aging into Medicare and strategic provider partnerships driving growth.

“The company is slowly building out its different provider services and increasing its use of member engagement strategy across its different health plans,” Halper wrote.


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