Health care companies are in a rush to consolidate vertically so they can control as many links in the medical supply chain as possible (see: the mammoth CVS-Aetna deal that married a retail prescription giant with a major insurer). Anthem, which is the largest for-profit component of the sprawling Blue Cross and Blue Shield insurance federation, is no different. In its 2018 full-year earnings report, Anthem CEO Gail Boudreaux emphasized the firm’s launch of its own pharmacy benefits manager following its decision last year to end a relationship with Express Scripts, which became a part of Anthem rival Cigna at the end last year. While the company’s decision to exit several Affordable Care Act markets hurt its overall membership numbers, growth in its Medicare and Medicaid managed care businesses helped offset the losses. Anthem’s full-year operating revenues increased modestly to $92.1 billion in 2018.