6 payer executives to observe in 2021
The previous yr has compelled well being plans to nimbly adapt to the calls for of a worldwide pandemic, together with huge spikes in demand for telehealth and new therapies—and shortly, vaccines—coming to market.
These adjustments, particularly the now-larger marketplace for digital visits and digital care, are more likely to keep it up past COVID-19. As such, well being plan executives who play a key function in advancing these applied sciences might be main gamers to observe within the coming months.
Different business traits embody the rising verticality of the insurance coverage market: Main payers now largely personal and function their very own pharmacy profit supervisor arms, and lots have a rising secure of suppliers who deal with sufferers straight.
Meaning gamers on the high a lot account for an more and more numerous slate of companies.
RELATED: 5 insurance coverage executives to observe in 2020
As we enter the downhill slide into 2021, listed below are only a few of the insurance coverage executives we’ll be keeping track of.
Karen Lynch, president of Aetna and incoming CEO of CVS Well being
When longtime CEO Larry Merlo steps down in February, Aetna chief Karen Lynch will ascend to the highest job at CVS Well being’s sprawling enterprise. Lynch joined CVS as a part of its acquisition of the well being plan in 2018.
Starting in March, Lynch took the lead on CVS’ response to the COVID-19 pandemic. She has spoken publicly a number of instances over the previous a number of months about the best way the pandemic is impacting psychological well being and behavioral well being providers.
Lynch has greater than 30 years of expertise within the healthcare business that additionally embody stints at Cigna and Magellan Well being Providers.
CVS spokesman T.J. Crawford mentioned in a tweet that when Lynch turns into the corporate’s CEO, she’ll be the world’s highest-ranked feminine CEO.
Wyatt Decker, CEO of OptumHealth
UnitedHealth Group’s Optum subsidiary has accounted for a lot of the insurer’s progress over the previous a number of quarters, with no enterprise phase rising greater than OptumHealth.
OptumHealth, which is headed by CEO Wyatt Decker, M.D., encompasses the healthcare big’s supplier providers, together with specialty and first care, and it serves 98 million prospects.
For example simply how shortly this enterprise line is rising: Within the third quarter of this yr alone, income per affected person was up 25%.
Decker joined Optum in 2019 from Mayo Clinic, the place he served as chief medical data officer and CEO of Mayo Clinic in Arizona. Throughout his tenure, Mayo Clinic in Arizona earned a slew of accolades together with the most secure instructing hospital within the U.S. and the highest hospital in Arizona as ranked by U.S. Information and World Report.
Tim Wentworth, CEO of Evernorth
Very similar to UnitedHealth, Cigna has seen a notable increase in its funds from its acquisition of Express Scripts, the nation’s largest pharmacy profit supervisor.
Constructing on that deal, Cigna introduced in September that it might rebrand its well being providers enterprise, which incorporates Express Scripts, as Evernorth and launch a slew of latest options below that umbrella.
Tim Wentworth, who helmed Express Scripts on the time of the acquisition, has been tapped to guide Evernorth and the subsidiary’s formidable objectives for analysis and innovation. Wentworth joined the PBM following its merger with Medco in 2012.
Evernorth launched in October one in every of its first new options: FamilyPath, an built-in fertility resolution. Cigna CEO David Cordani mentioned that Evernorth is tackling the event of those platforms with transparency in thoughts to keep away from merely prescribing options to the market.
Cheryl Pegus, president of Cambia Shopper Well being Options
Cheryl Pegus, M.D., has worn a number of hats at Pacific Northwest Blues insurer Cambia Well being Options and presently serves as president of Cambia Shopper Well being Options.
However later this month, she’s going to depart the insurer to turn into govt vice chairman of well being and wellness at Walmart, taking part in a key within the retail big’s ongoing push into the healthcare house. At Walmart, Pegus will spearhead growth of the corporate’s “daring healthcare imaginative and prescient.”
Within the function, Pegus will oversee 4,700 pharmacies, 3,700 imaginative and prescient facilities, Walmart Well being’s clinics, digital well being platforms and Walmart Insurance coverage Providers, the corporate’s newly launched insurance coverage brokerage.
At Cambia, she additionally performed a key function in driving the insurers’ response to the COVID-19 pandemic, and she or he was not too long ago honored by Fierce Healthcare as one in every of our 2020 Girls of Affect.
Rajeev Ronanki, chief digital officer at Anthem
Expertise has confirmed important within the face of COVID-19, each as demand for digital care choices skyrocketed and because the want for knowledge to trace the unfold and affect of the virus grew.
At Anthem, Rajeev Ronanki and his crew shortly joined up with synthetic intelligence startup CloudMedx to launch C19 Explorer, an analytics software that tracks and predicts the results of COVID-19.
And it is out there without spending a dime to public well being officers and group leaders who want entry to the information. Shoppers may buy a paid model of the platform that enables for extra personalised analytics stories primarily based on inner knowledge that’s uploaded into the system.
Whereas the platform does embody knowledge on constructive circumstances and mortality charges, it additionally examines the social determinants of well being and different knowledge units to measure the affect of COVID-19 past merely bodily well being.
Mike Mikan, president and CEO of Vivid Well being
Startup insurer Vivid Well being has made a notable splash available in the market with its rising geographic attain and important enterprise capital backing.
The corporate most not too long ago closed a $500 million funding spherical, bringing complete funding within the firm to over $1.5 billion since early 2016.
As well as, Vivid Well being additionally introduced plans to accumulate Model New Day Well being Plan, increasing its footprint in Medicare Benefit. Monetary phrases weren’t disclosed, however leaders at each corporations mentioned that the deal would permit for a mix of Vivid Well being’s tech-enabled method and Model New Day’s native and group ties.
The corporate operates in 43 markets throughout 13 states and brings in $1.2 billion in annual income.