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Corporation
HEALTHCARE | Healthcare Plans
antheminc.com

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Investments

15

Portfolio Exits

6

Partners & Customers

10

Service Providers

1

About Anthem

Anthem (NYSE: ANTM) is a health benefits company. The company provides health, dental and vision, and pharmacy benefits, as well as life insurance, and life and disability insurance benefits. Anthem offers a broad spectrum of network-based managed care plans to large and small employer, individual, Medicaid, and Medicare markets.

Anthem Headquarters Location

220 Virginia Avenue

Indianapolis, Indiana, 46204,

United States

(800) 331-1476

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Expert Collections containing Anthem

Expert Collections are analyst-curated lists that highlight the companies you need to know in the most important technology spaces.

Find Anthem in 3 Expert Collections, including Pharma Supply Chain.

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Pharma Supply Chain

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Conference Exhibitors

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Value-Based Care & Population Health

883 items

The VBC & Population Health collection includes companies that enable and deliver care models that address the health needs for defining populations along the continuum of care, including in the community setting, through participation, engagement, and targeted interventions.

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Research containing Anthem

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CB Insights Intelligence Analysts have mentioned Anthem in 1 CB Insights research brief, most recently on May 3, 2022.

Latest Anthem News

Medical coding creates barriers to care for transgender patients

Sep 13, 2022

Last year, Tim Chevalier received the first of many coverage denials from his insurance company for the hair removal procedure he needed as part of a phalloplasty, the creation of a penis. Electrolysis is a common procedure among transgender people like Chevalier, a software developer in Oakland, California. In some cases, it's used to remove unwanted hair from the face or body. But it's also required for a phalloplasty or a vaginoplasty, the creation of a vagina, because all hair must be removed from the tissue that will be relocated during surgery. Chevalier's insurer, Anthem Blue Cross, told him he needed what's known as a prior authorization for the procedure. Even after Chevalier received the authorization, he said, his reimbursement claims kept getting denied. According to Chevalier, Anthem said the procedure was considered cosmetic. Many trans patients have trouble getting their insurers to cover gender-affirming care. One reason is transphobia within the U.S. health care system, but another involves how medical diagnoses and procedures are coded for insurance companies. Nationwide, health care providers use a list of diagnostic codes provided by the International Classification of Diseases, Tenth Revision, or ICD-10. And many of those, advocates for transgender people say, haven't caught up to the needs of patients. Such diagnostic codes provide the basis for determining which procedures, such as electrolysis or surgery, insurance will cover. "It's widely regarded that the codes are very limited in ICD-10," said Dr. Johanna Olson-Kennedy , medical director of the Center for Transyouth Health and Development at Children's Hospital Los Angeles. She advocates for a move to the 11th edition of the coding system, which was endorsed by the World Health Organization in 2019 and began to be adopted around the globe in February. Today, more than 34 countries use ICD-11 . The new edition has replaced outdated terms like "transsexualism" and "gender identity disorder" with "gender incongruence," which is no longer classified as a mental health condition, but as a sexual health one. This is crucial in reducing the stigmatization of trans people in health care, said Olson-Kennedy. A move away from the mental health classification may also mean more coverage of gender-affirming care by insurance companies, which sometimes question mental health claims more rigorously than those for physical illnesses . WHO officials have said they hope that adding gender incongruence to a sexual health chapter will "help increase access to care for health interventions" and "destigmatize the condition," according to the WHO website . However, history suggests that ICD-11 likely won't be implemented in the U.S. for years. The WHO first endorsed ICD-10 in 1990, but the U.S. didn't implement it for 25 years . Meanwhile, patients who identify as transgender and their doctors are spending hours trying to get coverage — or using crowdfunding to cover big out-of-pocket bills. Chevalier estimated he has received 78 hours of electrolysis at $140 per hour, costing $10,920. Anthem spokesperson Michael Bowman wrote in an email that "there has been no medical denials or denial of coverage" because Anthem "preapproved coverage for these services." However, even after the preapproval was given, Anthem responded to Chevalier's claims by stating the electrolysis would not be reimbursed because the procedure is considered cosmetic, rather than medically necessary. This is regardless of Chevalier's diagnosis of gender dysphoria — the psychological distress felt when someone's biological sex and gender identity don't match — which many doctors consider a medically legitimate reason for hair removal. Bowman wrote that "once this issue was identified, Anthem implemented an internal process which included a manual override in the billing system." Still, Chevalier filed a complaint with the California Department of Managed Health Care, and the state declared Anthem Blue Cross out of compliance. Additionally, after KHN started asking Anthem questions about Chevalier's bills, two claims that had not been addressed since April were resolved in July. So far, Anthem has reimbursed Chevalier around $8,000. Some procedures that trans patients receive can also be excluded from coverage because insurance companies consider them "sex-specific." For example, a transgender man's gynecological visit may not be covered because his insurance plan covers those visits only for people enrolled as women. "There is always this question of: What gender should you tell the insurance company?" said Dr. Nick Gorton, an emergency medicine physician in Davis, California. Gorton, who is trans, recommends his patients with insurance plans that exclude trans care calculate the out-of-pocket costs that would be required for certain procedures based on whether the patient lists themselves as male or female on their insurance paperwork. For example, Gorton said, the question for a trans man becomes "what's more expensive — paying for testosterone or paying for a Pap smear?" — since insurance likely won't cover both. Related Stories For years, some physicians helped trans patients get coverage by finding other medical reasons for their trans-related care. Gorton said that if, for instance, a transgender man wanted a hysterectomy but his insurance didn't cover gender-affirming care, Gorton would enter the ICD-10 code for pelvic pain, as opposed to gender dysphoria , into the patient's billing record. Pelvic pain is a legitimate reason for the surgery and is commonly accepted by insurance providers, Gorton said. But some insurance companies pushed back, and he had to find other ways to help his patients. In 2005, California passed a first-of-its-kind law that prohibits discrimination by health insurance on the basis of gender or gender identity. Now, 24 states and Washington, D.C., forbid private insurance from excluding transgender-related health care benefits . Consequently, Gorton no longer needs to use different codes for patients seeking gender-affirming care at his practice in California. But physicians in other states are still struggling. When Dr. Eric Meininger , an internist and pediatrician at Indiana University Health's Gender Health Program , treats a trans kid seeking hormone therapy, he commonly uses the ICD-10 code for "medication management" as the primary reason for the patient's visit. That's because Indiana has no law providing insurance protections for LGBTQ+ people, and when gender dysphoria is listed as the primary reason, insurance companies have denied coverage. "It's frustrating," Meininger said. In a patient's billing record, he sometimes provides multiple diagnoses, including gender dysphoria, to increase the likelihood that a procedure will be covered. "It's not hard usually to come up with five or seven or eight diagnoses for someone because there's lots of vague ones out there." Implementing ICD-11 won't fix all the coding problems, as insurance companies may still refuse to cover procedures related to gender incongruence even though it is listed as a sexual health condition. It also won't change the fact that many states still allow insurance to exclude gender-affirming care. But in terms of reducing stigma, it's a step forward, Olson-Kennedy said. One reason the U.S. took so long to switch to ICD-10 is that the American Medical Association strongly opposed the move. It argued the new system would put an incredible burden on doctors. Physicians would have to "contend with 68,000 diagnosis codes — a five-fold increase from the approximately 13,000 diagnosis codes in use today," the AMA wrote in a 2014 letter . Implementing software to update providers' coding systems would also be costly, dealing a financial blow to small medical practices, the association argued. Unlike past coding systems, ICD-11 is fully electronic, with no physical manual of codes, and can be incorporated into a medical facility's current coding system without requiring a new rollout, said Christian Lindmeier, a WHO spokesperson. Whether these changes will make the adoption of the new edition easier in the U.S. is yet to be seen. For now, many trans patients in need of gender-affirming care must pay their bills out-of-pocket, fight their insurance company for coverage, or rely on the generosity of others. "Even though I did get reimbursed eventually, the reimbursements were delayed, and it burned up a lot of my time," Chevalier said. "Most people would have just given up." This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

Anthem Investments

15 Investments

Anthem has made 15 investments. Their latest investment was in Somatus as part of their Series E on February 2, 2022.

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Anthem Investments Activity

investments chart

Date

Round

Company

Amount

New?

Co-Investors

Sources

2/23/2022

Series E

Somatus

$325M

No

12

1/13/2022

Seed VC

Avaneer Health

$50M

Yes

14

11/3/2021

Corporate Minority

Somatus

Yes

1

5/5/2021

Series B - II

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$99M

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10

4/7/2021

Corporate Minority - III

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$99M

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10

Date

2/23/2022

1/13/2022

11/3/2021

5/5/2021

4/7/2021

Round

Series E

Seed VC

Corporate Minority

Series B - II

Corporate Minority - III

Company

Somatus

Avaneer Health

Somatus

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Amount

$325M

$50M

$99M

$99M

New?

No

Yes

Yes

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Co-Investors

Sources

12

14

1

10

10

Anthem Portfolio Exits

6 Portfolio Exits

Anthem has 6 portfolio exits. Their latest portfolio exit was Physicians Immediate Care on July 07, 2022.

Date

Exit

Companies

Valuation
Valuations are submitted by companies, mined from state filings or news, provided by VentureSource, or based on a comparables valuation model.

Acquirer

Sources

7/7/2022

Acquired

$99M

2

7/16/2021

IPO

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$99M

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10

7/1/2021

Reverse Merger

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$99M

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10

2/3/2014

Acq - Fin

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$99M

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10

12/1/2009

Divestiture

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$99M

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10

Date

7/7/2022

7/16/2021

7/1/2021

2/3/2014

12/1/2009

Exit

Acquired

IPO

Reverse Merger

Acq - Fin

Divestiture

Companies

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Valuation

$99M

$99M

$99M

$99M

$99M

Acquirer

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Sources

2

10

10

10

10

Anthem Acquisitions

18 Acquisitions

Anthem acquired 18 companies. Their latest acquisition was Integra Managed Care on May 05, 2022.

Date

Investment Stage

Companies

Valuation
Valuations are submitted by companies, mined from state filings or news, provided by VentureSource, or based on a comparables valuation model.

Total Funding

Note

Sources

5/5/2022

$99M

Acquired

1

11/10/2021

$99M

Acquired

4

3/24/2021

Other

$99M

$18.13M

Acquired

4

2/2/2021

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$99M

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10

7/29/2020

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$99M

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10

Date

5/5/2022

11/10/2021

3/24/2021

2/2/2021

7/29/2020

Investment Stage

Other

Companies

Subscribe to see more

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Valuation

$99M

$99M

$99M

$99M

$99M

Total Funding

$18.13M

Note

Acquired

Acquired

Acquired

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Sources

1

4

4

10

10

Anthem Partners & Customers

10 Partners and customers

Anthem has 10 strategic partners and customers. Anthem recently partnered with Twill on June 6, 2022.

Date

Type

Business Partner

Country

News Snippet

Sources

6/7/2022

Partner

United States

Anthem, Inc. Aims to Enhance Maternal Health with New Digital-First Solution

Anthem , Inc. partners with Happify Health to bring innovative digital health services to areas of women 's health including pregnancy , menopause , and more

1

5/24/2022

Partner

United States

Anthem and Google partner on synthetic data sets for algorithm training

Anthem and Google Cloud have partnered to create synthetic data sets that can train algorithms to detect fraud .

1

5/10/2022

Partner

Iceland

Digital Therapeutics Leader Sidekick Raises $55M Series B To Drive Further Growth.

Sidekick Health operates its platform in partnership with some of the biggest names in healthcare , including leading US-based health company Anthem Inc. to offer a digital-first care programs , as well as global pharmaceutical majors such as Pfizer and Bayer , to develop integrated combination therapeutics consisting of a molecular drug and a digital therapeutic .

1

4/20/2022

Partner

United States

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10

11/4/2021

Partner

United States

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10

Date

6/7/2022

5/24/2022

5/10/2022

4/20/2022

11/4/2021

Type

Partner

Partner

Partner

Partner

Partner

Business Partner

Country

United States

United States

Iceland

United States

United States

News Snippet

Anthem, Inc. Aims to Enhance Maternal Health with New Digital-First Solution

Anthem , Inc. partners with Happify Health to bring innovative digital health services to areas of women 's health including pregnancy , menopause , and more

Anthem and Google partner on synthetic data sets for algorithm training

Anthem and Google Cloud have partnered to create synthetic data sets that can train algorithms to detect fraud .

Digital Therapeutics Leader Sidekick Raises $55M Series B To Drive Further Growth.

Sidekick Health operates its platform in partnership with some of the biggest names in healthcare , including leading US-based health company Anthem Inc. to offer a digital-first care programs , as well as global pharmaceutical majors such as Pfizer and Bayer , to develop integrated combination therapeutics consisting of a molecular drug and a digital therapeutic .

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Sources

1

1

1

10

10

Anthem Service Providers

1 Service Provider

Anthem has 1 service provider relationship

Service Provider

Associated Rounds

Provider Type

Service Type

IPO

Investment Bank

Financial Advisor

Service Provider

Associated Rounds

IPO

Provider Type

Investment Bank

Service Type

Financial Advisor

Partnership data by VentureSource

Anthem Team

65 Team Members

Anthem has 65 team members, including current Founder, President, Cynthia French Blanchard.

Name

Work History

Title

Status

Cynthia French Blanchard

Founder, President

Current

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Name

Cynthia French Blanchard

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Work History

Title

Founder, President

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Status

Current

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