MMIT Payer Portrait: Cambia Health Solutions

With its roots in the health insurance industry stemming back to 1917, Cambia Health Solutions is a nonprofit health insurance company and member of the Blue Cross Blue Shield Association, offering Blues products in Idaho, Oregon, Utah and Washington. Known as The Regence Group until 2013, Cambia operates four regional managed care organizations under its Regence BlueCross BlueShield branding. Outside of its Blues brands, Cambia also operates BridgeSpan Health Company, which focuses on Affordable Care Act exchange products, and Asuris Northwest Health, a community-based insurer offering commercial and Medicare Advantage plans in Washington state.

Cambia is a partial owner of its pharmacy benefits manager, Prime Therapeutics, the PBM owned and operated by 18 other Blues affiliates. Alliance Rx Walgreens Prime, the PBM’s specialty pharmacy partnership with Walgreens, handles much of Cambia’s specialty contracting.

In October 2019, Cambia’s plans for a “strategic affiliation” with Blue Cross and Blue Shield of North Carolina were suspended following then-Blue Cross NC CEO Patrick Conway’s arrest for driving while intoxicated. While the deal was never referred to as a merger or acquisition, the two companies were to share administrative and operational services under Cambia’s branding and Conway’s leadership. While Cambia seemingly had ambitions to expand to the East Coast, the company has yet to revisit a similar deal with another insurer.

Most recently, Cambia has focused on health equity, donating $11.5 million to rural mental health organizations throughout its service area, and member experience. Fueled by the challenges of COVID-19-related lockdowns, the insurer in August 2020 launched Journi, a solutions platform for employer group members that serves as a telehealth facilitator, financial planning tool and provider search guide. It also grants access to whole-person health programs such as behavioral health support, nutrition, employee assistance and other wellness-related initiatives. The Journi app is available to employer groups nationwide.

SOURCE: AIS’s Directory of Health Plans as of November 2021; MMIT Analytics as of 3Q 2021.

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