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Anthem scoops up HMO to boost government business

By Healthcare Finance Staff

As the second largest health insurer formerly known as WellPoint nurtures the new corporate Anthem brand, it's also continuing to grow its presence in the government-funded health plan space.

Anthem, Inc. has agreed to purchase Simply Healthcare, the parent company of Simply Healthcare Plans and Better Health, two managed care organizations serving Medicare and Medicaid beneficiaries in Florida.

Together, Simply Healthcare Plans and Better Health serve about 170,000 Medicaid beneficiaries, more than 100,000 of them HIV/AIDS patients, and 22,000 Medicare beneficiaries, across 60 of Florida's 67 counties.

"This acquisition aligns with Anthem's strategy for continued growth in our government business division," said Anthem president and CEO Joseph Swedish. "Simply Healthcare's strong presence and solid provider relationships further strengthens our Medicaid and Medicare companies' positioning and advances the companies' capabilities to more effectively and efficiently serve these populations in Florida, a key market for growth."

The acquisition of Simply Healthcare will add another roughly 200,000 members to Anthem's Amerigroup Medicaid-Medicare subsidiary, which serves 2.8 million members in 12 states. In Florida, the takeover will leave Anthem with 500,000 members, including 106,0000 HIV/AIDS patients covered by Simply Healthcare's Clear Health Alliance, the state's only HIV/AIDS special needs plan.

Simply Healthcare was founded through the merger of two small HMOs in 2009 by Miguel Fernandez, a healthcare-focused entrepreneur and chairman of Coral Gable-based MBF Healthcare Partners; early the next year, the investment outfit injected $50 million in equity.

With less than 40,000 members, the company was put under the leadership of Peter Jimenez, a managed care veteran who previously worked at Physician Healthcare Plans (acquired by a pre-Anthem-owned Amerigroup in 2002) and Care Plus Health Plans (acquired by Humana in 2005).

Simply Healthcare expanded in Medicaid and Medicare, and in 2012 inked an investment and strategic affiliation deal with Magic Johnson, in tandem with the launch of the Clear Health Alliance HIV/AIDS plan.

All along the strategy has been "aggressively pursuing acquisition opportunities," as Fernandez said in 2010, adding that Anthem's takeover "validates the quality of the company management and the team Simply has built."

Simply Healthcare Plans' CEO, Lourdes Rivas, who's also an operating advisor at MBF, said Anthem shares the vision for helping beneficiaries achieve "optimal health through an outstanding network of providers and high touch, local customer service."

Financial terms of Anthem's acquisition were not disclosed; the deal is expected to close in the first half of 2015, subject to regulatory approvals.

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