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Analysis

Health care's big players boxing out the little guys

Using tactics that have drawn the attention of federal regulators and attracted lawsuits, drug plans and insurers have boxed out their smaller partners so they can take the business for themselves.

By Robert Langreth | Updated on March 13, 2018
Man held in cage Small operators in the health-care industry are seeing their profits squeezed by a tightly interwoven web of distributors, retailers and health-plan administrators. (Photo: Shutterstock)

Over 20 years, Brian Komoto built a thriving pharmacy in California’s Central Valley. Each day, his nurses would travel the vast agricultural region’s roads to help hepatitis C patients take a grueling regimen of shots.

Then, in 2016, 20 percent of Komoto’s business vanished, practically overnight. The insurer Centene Corp. purchased the health plan that covered his patients — many of them Hispanic farm workers who had developed a level of trust with Komoto’s traveling nurses. Centene had its own mail-order pharmacy, and it told the patients to go there instead, he said.

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