Get Connected:

 

Express Scripts to Acquire Medical Benefit Management Company

Offering medical and pharmacy benefit management can advance the move towards value-based care.
Published Online: Oct 12,2017
Laurie Toich, Assistant Editor
Recently, pharmacy benefit manager (PBM) Express Scripts announced that it plans to acquire eviCore healthcare—a leader in evidence-based medical benefit management (MBM) services—for $3.6 billion, according to a press release.

According to the PBM, combining Express Scripts’ expertise in pharmacy benefit management with eviCore’s MBM experience will create a unique and integrated patient benefit solution.

The final acquisition is expected to occur in the fourth quarter of 2017, but the deal is subject to regulatory approval and other conditions.

"The rising cost of healthcare is one of the most important issues facing Americans today," said Tim Wentworth, president and CEO of Express Scripts. "Together with eviCore, Express Scripts will be an even more powerful partner in managing costs for patients and payers, bringing us closer to our goal of becoming the nation's leading patient benefit manager. By further strengthening our independent model and creating numerous opportunities for growth, the acquisition of eviCore will deliver value for our clients, patients, providers, and shareholders."

eviCore manages medical benefits for more than 100 million patients and offers integrated MBM solutions that can reduce costs and improve quality outcomes.

The company currently contracts with all health plans and manages benefits in radiology, cardiology, musculoskeletal disorders, post-acute care, and medical oncology, which all require increased cost management, according to the release.

This acquisition will allow Express Scripts to enter the healthcare spending space, which reaches nearly $3.4 trillion annually. By establishing its place in this market, Express Scripts will be able to create numerous new solutions that can be implemented by both pharmacy and medical benefit clients to reduce costs, according to the release.

This move also enables Express Scripts to further the push towards value-based care and increase pressure on payers to provide better services and solutions, according to the release. 

"The greatest opportunity to improve healthcare is by reducing wasteful spend and overutilization while delivering quality outcomes," said John Arlotta, chairman and CEO of eviCore. "Together, eviCore and Express Scripts will be uniquely positioned to tackle these problems. We are proud of what we have accomplished over 25 years of serving patients and clients and we are excited about our future with Express Scripts."