Walmart, Humana move closer as separate upheavals threaten

Different threats from major shifts in two industries are pushing Walmart and health insurer Humana toward the same solution.

Amazon.com has taken direct aim at the giant retailer by siphoning customers out of its stores. Humana's rivals are striking deals to make them one-stop health superstores with insurance, drug coverage, pharmacies, clinics, and doctors. A deal or joint venture between Humana and Walmart — already longtime partners — might help defend against those competitive threats.

The companies haven't publicly commented on reports Thursday that they were weighing a closer relationship or a merger, and it's not clear whether they will go forward with one, or what form it might take. A person familiar with the discussions told Bloomberg the pair are mainly considering a closer partnership to provide care to consumers at or near their homes, helping them manage or prevent illness.

Walmart would be able to steer Humana's millions of customers to the chain's stores, create new medical and wellness services in its millions of square feet of retail space, and take a bigger slice of the U.S.'s $3.5 trillion in health spending. Humana would get access to thousands of brick-and-mortar locations to provide low-cost health services, fitting into the insurer's strategy of providing more medical care directly to its members.

"Obviously, a lot of things have to go right for this vision to come to fruition, but if they can pull it off it will be an absolute game-changer in health care," Chas Roades, the cofounder of consulting firm Gist Healthcare, said by email.

Walmart runs 4,700 U.S. pharmacies and has been eyeing health care for years, though it hadn't publicly settled on a strategy. The company agreed to offer Medicare plans with Humana in 2010, and struck a deal to provide healthy-food discounts to some Humana customers in 2012. It has discussed building out physician clinics for years, but now has just 19 and recently said it wasn't planning to add more.

Humana has been opening medical clinics and operates nearly 200 locations with about 1,500 physicians. Its Humana at Home business cares for members where they live, avoiding costly hospital stays, and the company is bolstering that unit through a deal with private-equity partners to buy part of Kindred Healthcare.

"You can see the strategy by which they could make investments that make people healthier for a patient that's both a Humana enrollee and a Walmart customer," said Craig Garthwaite, a professor of strategy at Northwestern University's Kellogg School of Management. "These are the types of deals we should expect if you believe we're remaking the business model in health care."

Humana specializes in private Medicare plans for U.S. seniors, known as Medicare Advantage, though rivals such as UnitedHealth Group and Aetna are threatening its position. The Medicare Advantage program offers insurers strong financial incentives to keep their customers healthier and manage costs by giving the plans a fixed sum of money to take care of each customer for a year, based in part on how sick the person is.

CVS Health Corp. already employs a similar strategy. It has more than six million people enrolled in Medicare drug plans, whom it can steer to its retail locations to pick up their pills. A pending takeover of Aetna for about $68 billion will enhance that position. The companies also plan to create health hubs to care for individuals in CVS stores.

Other health-care rivals are consolidating, as well, using the combinations to simplify a complex web of intermediaries to take more control of patients' care.

UnitedHealth's Optum unit is spending billions to acquire physicians groups, most recently agreeing to pay $4.9 billion for DaVita Medical Group. In early March, insurer Cigna Corp. struck a $54 billion deal for pharmacy-benefits firm Express Scripts Holding Co.

Ana Gupte, an analyst at Leerink Partners, has been telling investors for months that Walmart was likely to make a play for Humana. She has pointed out that Walmart and Humana already have a co-branded Medicare prescription drug plan that brings customers into the stores, and that a tie-up offers strategic benefits for both sides.

She estimates that Walmart would pay about $50 billion for Humana, though she said any transaction is likely to face antitrust scrutiny, especially given other deals in health care.

"We expect the stores would become a channel for Humana Medicare Advantage seniors to be steered toward chronic-care management and other services, in addition to retail pharmacy," Gupte said. For Walmart, she called it "an opportunity to cross-sell health and wellness and other merchandise."

It would also help the retailer find new uses for store space that's less needed as customers shift to shopping online, said Garthwaite, the Northwestern professor. Already, Walmart has taken steps to deal with excess real estate. The company in January said it would close 63 Sam's Club locations, converting some into warehouses dedicated to filling online orders instead.

"Walmart has already paid some of the fixed costs," Garthwaite said. "They built out a big retail footprint when we used to buy a lot more things in retail stores."