Datapoint

IBX Launching New Primary Care-Focused MA Initiative

Pennsylvania Blues leader Independence Blue Cross last week unveiled a new primary care-focused initiative for a segment of its Medicare Advantage members. Through a partnership with Patina Medical Group, Independence will offer personalized, value-based care-focused primary care services such as virtual and in-home visits, appointment scheduling and access to specialized resources based on social needs. Independence is currently the fifth-largest MA insurer in Pennsylvania, with 102,910 members. CVS Health Corp.’s Aetna is the market leader at 371,845 members.

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Datapoint: UCare Seeks to Join Iowa Medicaid Program

Minneapolis-based nonprofit insurer UCare last week revealed it will bid to serve Iowa’s Medicaid managed care program. The state is seeking a third MCO for its Iowa Health Link program, which is currently served by Centene Corp. (332,657 lives) and Anthem, Inc.’s Amerigroup (449,390 lives). Awards are expected this summer, with with contracts beginning in July 2023.

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Datapoint: Maine to Merge, Individual Small Group Markets 

The state of Maine will merge its Affordable Care Act-based individual and small group markets for the 2023 plan year, according to a Feb. 17 report in the Portland Press Herald. It will be the first state to do so. The Maryland Bureau of Insurance told the news outlet that the merger will promote stability in the marketplace by merging the two risk pools. Maine’s small group market currently enrolls 51,013 lives, while 66,638 people are enrolled in the individual market.

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Datapoint: CareSource Announces Network of Pediatric ACOs in Ohio

CareSource, one of the largest Medicaid insurers in the U.S., last week unveiled plans to form a statewide network of pediatric accountable care organizations in Ohio. The CareSource Kids Collaborative will partner with children’s hospital groups in the state, using value-based care to “improve quality, efficiency and patient experience.” With 1,377,062 members, CareSource currently enrolls 50.4% of Ohio’s Medicaid program.

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Datapoint: Louisiana Announces Medicaid Contract Awards

The state of Louisiana on Feb. 11 unveiled planned contract awards for its Medicaid managed care program, with the transition expected to begin in July. Four payers, Aetna, AmeriHealth Caritas, Anthem, Inc. and Centene Corp. are incumbents, while Humana Inc. will be a new entrant. UnitedHealthcare, which currently enrolls 504,697 Louisiana Medicaid members, was not selected to renew its contract. Louisiana’s Medicaid program currently serves 1,919,714 lives, with 91.6% enrolled in a managed care plan.

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Datapoint: Molina Sees Sharp Year-Over-Year Revenue Increase

Molina Healthcare ended 2021 with $27.8 billion in total revenue, up 43% from year-end 2020, according to earnings data released Feb. 9. The company ended the year with $659 million in net income. Molina currently serves 4,192,744 members, and is the fourth-largest managed Medicaid insurer in the U.S.

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Datapoint: Mississippi Lawmakers Seek to Bar Centene From Medicaid Program

A bill that recently passed in the Mississippi House of Representatives would bar the state from contracting with Centene Corp. for managed Medicaid services, according to local news outlets. Centene recently reached a $55 million settlement with the state over an overpayment dispute. Centene currently enrolls 175,601 Medicaid members in the state, 40.8% of the program.

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Datapoint: Centene’s 2021 Earnings Results

Centene Corp. ended 2021 with $126 billion in total revenue, up 13% from year-end 2020, according to a recent earnings call. The company ended the year with $3 billion in profits. Execs credited enrollment growth in Medicare and Medicaid, plus recent acquisitions of PantherX and Circle Health for the boost. Centene currently serves 20,618,092 members, making it the fourth-largest insurer in the U.S.

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Datapoint: Anthem Launches Virtual Primary Care in 11 States 

Anthem, Inc. this week unveiled new virtual primary care services to its commercial health plan members in 11 states. The benefits, offered through Sydney Health, include wellness visits, 24/7 urgent care and chronic disease management. The target states include some of Anthem’s largest commercial risk markets, including Virginia (781,285 members), Ohio (557,968 members) and Georgia (530,400). Anthem serves 6,344,000 commercial members nationwide.

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Datapoint: Medicaid Enrollment Up Nearly 19% From Pre-Pandemic

About 15 million people, including 6 million children, stand to lose Medicaid coverage following the expiration of the federal public health emergency, according to a new report from the Urban Institute. From March 2020 to January 2022, Medicaid enrollment spiked 19%, to 87.7 million lives, according to the latest update to AIS’s Directory of Health Plans.

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