Datapoint

Datapoint: Aetna Expects 100K Additional Exchange Members in 2022

CVS Health Corp. CEO Karen Lynch at the company’s third-quarter 2021 earnings call she expects Aetna’s Affordable Care Act exchange enrollment to reach more than 100,000 members in the 2022 plan year. Aetna previously exited the exchanges in 2018, citing financial losses in excess of $200 million. ACA enrollment reached 12,949,212 members in 2021, according to the latest update to AIS’s Directory of Health Plans. Market leader Centene Corp. enrolls 15.7% of that cohort, with 2,031,174 lives.

0 Comments

Datapoint: Minnesota Unveils Medicaid Contract Awards

The Minnesota Department of Human Services last week unveiled its latest Medicaid contract awards, valued at $3.87 billion. The contracts, granted to Blue Cross and Blue Shield of Minnesota, HealthPartners, Hennepin Health, Medica, UCare and new entrant UnitedHealthcare, cover about 600,000 children and qualifying parents in the Twin Cities metro area. Minnesota’s Medicaid managed care program currently serves 1,065,148 lives, with Blue Cross and Blue Shield of Minnesota as the market leader at 383,172 members.

0 Comments

Datapoint: Jefferson Health Completes Health Partners Plans Deal

Philadelphia-based health system Jefferson Health completed its deal to acquire Health Partners Plans. The 18-hospital system, a unit of Thomas Jefferson University Hospitals Inc, gained a 25% stake in the Medicare and Medicaid insurer in 2016, growing its share via deals with co-owners Einstein Healthcare Network, which Jefferson Health agreed to merge with in 2019, and Temple University Health System. Health Partners Plans currently serves 286,796 members in Pennsylvania, with more than 90% enrolled in a Medicaid product.

0 Comments

Datapoint: Blue Premier Saves $40 Million for UNC Health

UNC Health, the health system affiliated with the University of North Carolina, says Blue Cross and Blue Shield of North Carolina’s value-based care initiative, Blue Premier, saved one of its provider networks $40 million in 2020 alone. The provider group, UNC Health Alliance, also earned a 100% quality score from the program for the second year in a row. BCBS NC is currently the largest insurer in the state, serving 2,875,542 members, 31.2% of the insured population.

0 Comments

Datapoint: HAP Expands Provider Network With Aetna Deal

Health Alliance Plan (HAP), the fifth-largest health insurer in Michigan, last week unveiled a new partnership with Aetna that will greatly expand its national provider network. Beginning Jan. 1, 2022, HAP will become an Aetna Signature Administrator, granting HAP’s PPO members access to Aetna’s nationwide PPO network and services at CVS Health MinuteClinic locations. HAP currently serves 421,656 members, with 35.3% enrolled in commercial risk-based products.

0 Comments

Datapoint: ACA Benchmark Plan Premiums Drop 3% for 2022

CMS last week said the average monthly premium for benchmark plans (or second lowest-cost silver plans), the most common type of coverage received on the Affordable Care Act exchanges, will decrease by 3% in 2022. This is the fourth consecutive year of premium drops for benchmark plans. According to the latest update to AIS’s Directory of Health Plans, 12,949,212 people currently receive coverage through the exchanges.

0 Comments

Datapoint: Humana Expands to Eight New Maryland Counties

In 2022, Humana Inc. will offer Medicare Advantage plans on the Eastern shore of Maryland for the first time, expanding to eight new counties in the state. Kaiser Permanente is currently the MA market leader in Maryland, with 66,339 members, while Humana serves just 6,043 lives. Maryland has had a historically low MA penetration rate, reaching just 16.3% as of September 2021.

0 Comments

Datapoint: FDA Approves First Interchangeable Humira Biosimilar

The FDA last week approved Boehringer Ingelheim’s Cyltezo as the first interchangeable biosimilar for AbbVie’s Humira. It is the second U.S.-approved interchangeable biosimilar overall, behind Viatris and Biocon’s Semglee. Cyltezo was approved for a number of inflammatory conditions, including rheumatoid arthritis, Crohn’s disease, ulcerative colitis and psoriatic arthritis. For the treatment of rheumatoid arthritis, Humira holds preferred status under the pharmacy benefit for 11.6% of all covered lives, growing to 63.5% with utilization management restrictions applied.

0 Comments

Datapoint: Oscar Partners With Colorado Health Systems in Statewide Expansion Effort

Startup insurer Oscar Health is partnering with three Colorado health systems as it prepares to offer individual and family plans statewide for the 2022 plan year, per an Oct. 21 press release.

0 Comments

Datapoint: Kaiser Dominates 2022 Star Ratings

Among the largest Medicare Advantage insurers, Kaiser Permanente and its seven regional MCOs came out on top once again in CMS’s 2022 star ratings release, with 100% of its Medicare Advantage-Prescription Drug Plan (MA-PD) members enrolled in products with an overall five-star rating.

0 Comments