Third-Quarter DHP Update Puts COVID’s Impact Into Focus

AIS Health’s data team on Dec. 15 updated the Directory of Health Plans subscriber dashboard and in-app spreadsheets with new enrollment data. This data primarily reflects third-quarter 2020 status but includes fourth-quarter 2020 data for Medicare Advantage products and some Medicaid data, based on availability at the state level.

The update provides a clearer picture of the impact of the COVID-19 pandemic on the U.S. health insurance markets, particularly shifts from the commercial sector to Medicaid. Medicaid membership continued to climb in the early part of the quarter, though growth leveled off somewhat in November and December. Notable shifts in the Medicaid space include:

• Michigan, which saw the largest portion of its nearly 11% increase to 2.6 million lives in September, when it jumped 8% from the previous month.
• Puerto Rico, where Molina Healthcare’s November exit dispersed its 93,000 members to the U.S. territory’s remaining MCOs. Plan de Salud Menonita was the Commonwealth’s bigger winner, scooping up 55,000 new members since our last update.
• Hawaii’s managed Medicaid program also posted increases, due to both COVID-19 and to enhanced reporting from the state Medicaid division. UnitedHealthcare and Kaiser Foundation Health Plan of Hawaii both saw significant jumps in membership, to 56,000 and 38,000 lives, respectively.
• Texas saw its fee-for-service membership continue to decrease as its managed Medicaid plans increased; the State of Texas lost 67,000 members as it continues to transition beneficiaries into managed care. California, Illinois, Minnesota, Virginia and Georgia are seeing similar shifts.

Group commercial risk enrollment is still on the decline, but not to the degree that was expected, dropping from 70.5 million to 69.7 million since the second quarter of 2020. Some insurers did take hits, including FirstCare Health Plans, which lost almost 22,000 members, and UnitedHealthcare, which saw significant decreases in its California, Nevada and Washington markets.

Other notable enrollment shifts since last quarter centered around losses in the self-funded, non-risk category, which can likely be attributed to the pandemic’s impact as these are largely employer-based contracting arrangements. Aetna lost 508,000 ASO members, followed by UnitedHealthcare, which lost 385,000, while Cigna Corp. and Anthem, Inc. lost 237,000 and 190,000 members, respectively.

AIS’s Directory of Health Plans, a unit of MMIT, maintains payer data and tracks enrollment of health insurers each quarter, as well as their PBM and specialty pharmacy contracts. Contact sales@AISHealth.com to have this access added to your account. Subscribers can contact support@aishealth.com with questions about how to use or interpret the information provided to you in AIS’s Directory of Health Plans. A member of AIS Health’s support staff would be happy to provide a free demonstration of the website for clients needing more guidance on how to best use this tool.

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