Express Scripts Acquires Medical Benefit Managing Company eviCore Healthcare

Express Scripts recently announced the purchase of eviCore Healthcare for $3.6 billion, according to a press release.

eviCore Healthcare is a medical benefit management company that works with payers to determine whether or not imaging and tests are valuable or clinically necessary. Express Scripts stressed that through the additional benefit management provided by eviCore, price increases related to wasteful care should be somewhat relieved. 

“The rising cost of health care is one of the most important issues facing Americans today,” Tim Wentworth, president and CEO of Express Scripts, said in a press release. “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.”

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According to the press release, eviCore manages benefits for 100 million patients. It’s medical benefit management solutions provide payers with improve quality, improved outcomes, and significant cost savings. Their cost management solutions cover tests and imaging in  oncology, radiology, cardiology, musculoskeletal disorders, and post-acute care.

Express Scripts said that it will aim to cross sell these medical benefit management services to payers who already use Express Scripts for pharmacy benefit management solutions. They noted that the areas of health care managed by the eviCore solutions account for over $300 billion in annual spending—highlighting the need for better cost control.

“The greatest opportunity to improve health care is by reducing wasteful spend and overutilization while delivering quality outcomes,” John Arlotta, chairman and CEO of eviCore, said. “Together, eviCore and Express Scripts will be uniquely positioned to tackle these problems.”

—David Costill