Datapoint

Datapoint: Triple-S Approves GuideWell Acquisition

GuideWell Mutual Holding Corp.’s acquisition of Triple-S Management Corp. is one step closer to completion, as Triple-S’s stockholders on Monday approved the deal. With 991,758 members, Triple-S is the largest insurer in Puerto Rico, offering products across the spectrum of the health insurance market, notably group risk-based plans (247,651 members) and managed Medicaid (451,330 members). GuideWell is the parent company of Florida Blue, the largest insurer in Florida. The deal is expected to close in the second quarter of 2022, subject to regulatory approval.

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Datapoint: Bright Health Scores $750M From Cigna

Startup insurer Bright Health last week announced $750 million in funding from Cigna Ventures, Cigna Corp.’s investment arm, and co-investor New Enterprise Associates. The investment signals faith in the company’s NeueHealth segment, which operates more than 130 clinics. Bright Health currently covers 525,404 members, with 90.8% enrolled in Affordable Care Act exchange plans.

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Datapoint: HeatlhCare.Gov Sees 4.6 Million Sign-Ups So Far

As the last day of sign-ups approaches, the Biden administration on Dec. 9 announced that nearly 4.6 million people have selected coverage via HealthCare.gov for the 2022 plan year. CMS said 923,256 of these sign-ups are new to the exchanges. According to the latest update to AIS’s Directory of Health Plans, 12,949,212 people are currently enrolled in exchange plans nationwide.

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Datapoint: CareSource Sets Sights on Mississippi Medicaid

CareSource on Dec. 2 said it is partnering with TrueCare, a large provider-sponsored health organization in Mississippi, to serve Medicaid members in the state. The alliance will bid to serve Mississippi’s managed Medicaid and CHIP population in the next award period. Mississippi currently serves 475,168 managed Medicaid lives, with Centene Corp. leading the pack at 40.6% market share. CareSource covers 2,131,741 Medicaid members in five states.

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Datapoint: MetroPlus to Integrate Behavioral Health Into Primary Care

MetroPlus Health Plan, the insurance arm of NYC Health + Hospitals, on Dec. 6 said it will integrate behavioral health benefits into its medical coverage in an effort to move toward whole-person health and reduce unnecessary hospitalizations. MetroPlus also said it saw an 85% increase in behavioral telehealth services over the course of the COVID-19 pandemic. The insurer currently enrolls 611,163 members in New York, with about 80% enrolled in a Medicaid product.

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Datapoint: Aetna-Allina Health Launch New Plan Designs in Minnesota

CVS Health Corp.’s Aetna and Minneapolis-based health system Allina Health will launch four new plan designs for employer groups and self-insured clients in 2022, according to a Dec. 2 press release. The plans offer varied benefits, including streamlined benefit management and Aetna’s “flexible five” service, which offers 100% coverage for members first five health services in a given year. Aetna currently enrolls 1,551 self-funded members and 1,074 group-risk based members in the state.

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Datapoint: Oklahoma Medicaid Rolls Top 1M After Expansion

Since implementation of Oklahoma’s voter-backed Medicaid expansion began in July 2021, 207,564 additional people have received coverage in the state, according to the latest update to AIS’s Directory of Health Plans. Oklahoma covers 1,083,031 Medicaid beneficiaries as of November 2021, a 23.7% increase from pre-expansion days.

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Datapoint: Blue Cross and Blue Shield of Montana Plots Medicare Expansion

Blue Cross and Blue Shield of Montana, a subsidiary of Health Care Service Corp., on Nov. 8 unveiled plans to expand its Medicare Advantage products to five new counties in Montana. The insurer also outlined its 2022 MA benefits, which include $0 premium plans and no-copay provider visits. Humana is currently the MA market leader in Montana, serving 32,740 members, while BCBSMT snags the No. 2 spot with 14,295 members.

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Datapoint: Amgen Asks Supreme Court to Hear Repatha Case

Amgen is asking the U.S. Supreme Court to take up a previous ruling that invalidated two key patents for its PCSK9 drug, Repatha. A federal appeals court in June declined to hear the case. This is the latest chapter in a saga that dates back to 2014, when Amgen sued Sanofi and Regeneron to protect Repatha’s patents against a competing drug, Praluent, which ultimately delayed Praluent’s launch. For the treatment of atherosclerotic cardiovascular disease (ASCVD), Repatha holds covered or better status for 85% of all insured lives under the pharmacy benefit, compared to Praluent’s 76%.

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Datapoint: United to Join Massachusetts Duals Demo

UnitedHealthcare on Nov. 24 revealed it will join OneCare, Massachusetts’ CMS-backed demonstration for Medicare-Medicaid dual eligibles, in 2022. OneCare currently serves 31,628 duals, who are enrolled in plans offered by Tufts Health Plan and Commonwealth Care Alliance.

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