AIS’s Directory of Health Plans

Datapoint: Nebraska Awards Medicaid Contracts

The Nebraska Department of Health and Human Services last week awarded 5-year Medicaid contracts to three insurers: incumbents UnitedHealthcare and Centene Corp., plus new entrant Molina Healthcare. Current contract-holder Elevance Health was not selected. Nebraska’s managed Medicaid plans currently serve 360,243 people.

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Datapoint: Judge Says United Can Complete Change Healthcare Deal

A federal judge last week said UnitedHealth Group can complete its planned acquisition of Change Healthcare Inc. The Dept. of Justice previously sued UnitedHealth in an attempt to block the deal, alleging that acquiring Change would give UnitedHealth’s OptumInsight an anticompetitive edge in health data analytics. The judge, however, said the deal could go forward so long as UnitedHealth completes its announced plans to sell Change Healthcare's ClaimsXten division to private equity fund TPG Capital for $2.2 billion. With 46,614,669 members, UnitedHealth is the largest insurer in the U.S.

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Datapoint: Appeals Court Upholds Kentucky Medicaid Awards

A panel of Kentucky appellate judges upheld the state’s challenged managed Medicaid contract awards, according to a Sept. 15 report in the Louisville Courier Journal. A lower court previously ordered the 2020 awards rebid, following a suit from Elevance Health, which was not initially selected to keep its contract. Parties have until Oct. 9 to further appeal the decision. Kentucky’s managed Medicaid population is currently served by six MCOs, led by Centene Corp., with 484,498 members. Elevance, meanwhile, serves 171,734 Kentucky Medicaid lives.

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Datapoint: Highmark Launching New Primary Care Initiative in Pittsburgh

Highmark Health is partnering with value-based primary care provider AbsoluteCare to bring concierge-style primary care services to its public-sector members in Pittsburgh. Members will have access to same-day urgent care, behavioral health services and a pharmacy on-site. AbsoluteCare also operates in Atlanta, Baltimore, New Orleans and Philadelphia. Highmark is the largest insurer in Pennsylvania, with 2,342,027 members. It serves 324,557 managed Medicaid beneficiaries in the state.

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Datapoint: Oregon Adds Mobile Crisis Intervention to Medicaid Program

Oregon is launching a first-of-its-kind mobile crisis intervention program for its Medicaid population, according to CMS. Medicaid beneficiaries experiencing substance abuse or mental health issues will be able to contract a behavioral health specialist 24 hours per day. CMS said these programs can reduce costs for inpatient mental health treatments and burdens on law enforcement. Oregon currently serves 1,300,577 Medicaid beneficiaries.

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Datapoint: Iowa Awards Medicaid Contracts

Iowa’s Dept. of Health and Human Services on Aug. 31 unveiled new Medicaid contract awards for Elevance Health and Molina Healthcare, which will join Centene Corp. in serving the state’s managed Medicaid program. Elevance Health’s Amerigroup Iowa already serves Iowa’s Medicaid population, while Molina will be a new entrant. “This third MCO will enhance choice for members and incent innovation in the Iowa Medicaid program, “the state’s announcement read. “The new contracts are slated to begin July 1, 2023. Centene and Elevance currently serve 784,752 Iowa Medicaid lives combined.

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Datapoint: Wellmark, UnityPoint Partner on Exchange Products

Wellmark Blue Cross and Blue Shield of Iowa and UnityPoint Health, a large, Des Moines-based health system, are partnering to offer Affordable Care Act exchange products in Iowa for the 2023 plan year. Benefits will include low-cost copays for primary care visits, and $0 telehealth. Wellmark is currently the largest insurer in Iowa, with 1,084,489 members, or 30.7% of the overall market. It is also the exchange market leader in the state, with 29,000 members.

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Datapoint: Aetna to Expand ACA Market in 12 States

After re-entering the Affordable Care Act exchange markets for the 2022 plan year, CVS Health Corp.’s Aetna last week said it will expand its product offerings in 12 states, in both new and existing markets. The new state markets include Arizona, California, Illinois and North Carolina. The insurer currently enrolls 27,800 exchange members, with Florida (about 10,000 members) and Texas (about 7,000 members) as its largest state markets.

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Datapoint: United Expanding Exchange Presence to Four New States

UnitedHealthcare intends to offer Affordable Care Act exchange products in four new states — Kansas, Mississippi, Missouri and Ohio — for the 2023 plan year, according to a Sept. 6 report in the Star Tribune. The expansion, if approved by regulators, would bring United’s exchange presence to 22 states. UnitedHealthcare is currently the 12th-largest exchange insurer in the U.S., with 337,701 members.

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Datapoint: Cigna Unveils Exchange Market Expansions for 2023

Cigna Corp. will offer Affordable Care Act exchange products in three new states, while expanding its existing market to 50 new counties overall, according to an Aug. 29 press release. The new states are Indiana, South Carolina and Texas. Cigna currently ranks 11th in national ACA enrollment, with 340,000 members. Tennessee is its largest state exchange market, with 85,000 members.

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