Sun Life To Buy Healthcare Navigation Firm PinnacleCare For $85 Million

Sun Life Financial will acquire medical intelligence and healthcare navigation provider PinnacleCare International, Sun Life announced Friday (April 23).

The $85 million deal will make PinnacleCare part of Sun Life’s Stop-Loss & Health business, which is the largest stop-loss provider in the U.S., per the announcement. The transaction is expected to close in the middle of the year, pending regulatory approval and other closing conditions.

Based in Baltimore, 20-year-old PinnacleCare employs more than 170 people and helps clients access an initial or second medical opinion so they can make informed treatment decisions after receiving complicated diagnoses.

PinnacleCare already offers its services to more than 2 million people. With Sun Life’s larger distribution network and relationships with employers, PinnacleCare will be able to reach even more people while still serving existing clients, the companies say.

“The acquisition will expand Stop-Loss & Health beyond the traditional model that reimburses employers for the costs of serious health conditions after an employee’s care has occurred,” the company news release said. “Through PinnacleCare, Stop-Loss & Health will engage with the employee at diagnosis to help improve the entire spectrum of the care experience and outcomes for both the employee and employer. The transaction will create an integrated offering unique in the stop-loss market.”

Sun Life says PinnacleCare fills a “largely unmet” need in U.S. healthcare, helping guide people with sudden and serious illnesses to connect them with providers for the conditions. The company also conducts medical research, issues written and video-based second opinions and appointment setting through customers health plans.

“We are thrilled to bring PinnacleCare and its clinical expertise to Sun Life. By offering experienced care navigation for members, Sun Life and PinnacleCare will create a new dynamic that will improve care, outcomes and costs in the process,” said Dan Fishbein, M.D., president of Sun Life U.S. “PinnacleCare extends the value of our stop-loss programs beyond reimbursement to directly helping members in the moments that matter.”

The deal comes at a time when customers want their healthcare experiences to resemble the rest of their digital consumer experiences, as PYMNTS touched on in a recent report.

To learn more about the challenges and opportunities facing healthcare payers, read our interview from earlier this week with Colin Mellon, vice president of healthcare and insurance solutions at Fiserv.