News Briefs

Centene Corp. on Aug. 17 said the Ohio Dept. of Medicaid (ODM) made the long-awaited decision to renew its managed Medicaid contract with subsidiary Buckeye Health Plan. ODM in April named six other managed care organizations that will serve its newly redesigned Medicaid program starting in 2022 but deferred its decision on Buckeye, since Centene’s pharmacy benefit management practices were the subject of litigation at the time. Centene has since reached a no-fault agreement with the state and made some changes to its pharmacy benefit structure. “We are humbled and honored to continue to offer high-quality healthcare services and programs for our members,” said Brent Layton, president of U.S. markets, products and international, in a press release from Centene. Meanwhile, Centene was also one of three MCOs chosen to renew their managed Medicaid pacts with Nevada. For contacts starting Jan. 1, 2022, the Nevada Dept. of Health and Human Services selected units of UnitedHealthcare and Anthem, Inc., and new entrant Molina Healthcare of Nevada, Inc.

A new Kaiser Family Foundation (KFF) analysis finds that spending for Medicare Advantage enrollees was $321 higher per person in 2019 than if enrollees had been in traditional Medicare, generating an additional $7 billion in Medicare costs. Applying an MA payment reduction of 2%, as recommended in a recent Medicare Payment Advisory Commission report, could lower total Medicare spending by $82 billion through 2029, estimates KFF. As MA penetration continues to grow and the Biden administration seeks way to extend the solvency of the Medicare Hospital Insurance Trust Fund, the KFF “analysis suggests that reducing the difference in payments between Medicare Advantage and traditional Medicare would generate savings, with the potential for reductions in extra benefits for Medicare Advantage enrollees,” conclude researchers.

© 2023 MMIT
Lauren Flynn Kelly

Lauren Flynn Kelly Managing Editor, Radar on Medicare Advantage

Lauren has been covering health business issues, including drug benefits and specialty pharmacy, for more than a decade. She served as editor of Drug Benefit News (the predecessor to Radar on Drug Benefits) from 2004 to 2005 and again from 2011 to 2016, and now manages Radar on Medicare Advantage. Lauren graduated from Vassar College with a B.A. in English.

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