AIS’s Directory of Health Plans

Datapoint: Elevance Launching Weight Management Program

Elevance Health’s PBM unit CarelonRx is launching a digital-first weight loss management program in the coming weeks, according to a Feb. 26 press release. The program will grant participants access to digital coaching and wellness tools, plus live support for managing and monitoring weight loss goals. Participants who are prescribed GLP-1s will be able to use an additional companion module “designed to provide medication management support with a member’s prescribing physician.” The program will be available to ASO integrated clients, according to Elevance. Elevance is currently the second-largest self-funded insurer in the U.S., with 20,166,000 ASO members.

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Datapoint: Aetna Sees Strong MA Growth

CVS Health’s Aetna grew its Medicare Advantage rolls by 18.9% during the annual enrollment period, according to the latest public-sector update to AIS’s Directory of Health Plans. It’s the most growth of any large carrier by a wide margin, beating out MA stalwarts Humana Inc. (3.1% growth) and UnitedHealthcare (1.6% growth). Aetna expanded its footprint to 255 new counties for the 2024 plan year, offering new $0 premium plans and enhanced products for dual eligibles. The payer currently ranks third nationally in MA enrollment, serving 3,970,500 members.

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Datapoint: Is Medicaid Expansion Coming to Mississippi?

Mississippi lawmakers last week introduced a bill that would bring Medicaid expansion to the state with one major caveat — work requirements. The effort could bring Medicaid coverage to an estimated 250,000 people, provided they have a job, are seeking employment or pay a yet-undetermined premium for care. Governor Tate Reeves (R) strongly opposes Medicaid expansion, however, so the bill’s future is unclear. Mississippi currently serves 788,887 Medicaid beneficiaries, with 58% enrolled in managed care plans.

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Datapoint: Baystate to Sell Health Plan to Point32Health

Springfield, Mass.-based Baystate Health will sell its insurance subsidiary, Health New England, to fellow integrated system Point32Health, according to a Feb. 15 press release. The deal would grow Point32Health’s membership by 11%, to more than 1.7 million lives. “We are excited at the possibility of welcoming Health New England into the Point32Health family of companies,” Cain A. Hayes, president and CEO of Point32Health, said in a statement. “As two health plans that serve commercial, Medicaid and Medicare populations in Massachusetts, we have the shared commitment and expertise to serve people of all socioeconomic backgrounds, especially the underserved, and to improve members’ quality of life through programs and services that improve whole person health.” Point32Health is currently the second-largest insurer in its home state, behind Blue Cross Blue Shield of Massachusetts.

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Datapoint: Cigna, HelloFresh Partner on Meal Kit Benefits

Cigna Healthcare announced on Feb. 13 a partnership with HelloFresh, a meal kit company. The deal allows Cigna’s employer clients the opportunity to provide their beneficiaries discounted access to HelloFresh’s meal kits. Cigna and its employer clients are also participating in HelloFresh’s Meals with Meaning program, which provides free meal kits to people experiencing food insecurity. In December, Cigna’s employer clients delivered nearly 3,500 HealthFresh meals to their employees in underserved areas. Cigna currently serves 2,224,000 employer group risk-based members, and an additional 13,785,000 members via self-funded plans.

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Datapoint: SCAN, CareOregon Nix Merger Plans

More than a year after unveiling their intent to form HealthRight Group, SCAN Group and CareOregon have abandoned their plans to combine. According to news reports, the parties called off their proposed combination on Feb. 13 after the Oregon Health Authority twice delayed offering a recommendation on whether to approve the deal, which would have created a $6.8 billion Medicaid and Medicare Advantage insurer. “Our intent in coming together was to support Oregon’s healthcare system and the people that CareOregon serves,” said SCAN, the parent company of Medicare Advantage insurer SCAN Health Plan. However, despite our efforts, there are still questions about our combination. As a result, SCAN Group and CareOregon have mutually agreed to withdraw our applications with the Oregon regulatory agencies and to terminate our affiliation agreement.” The combined insurer would have served 845,539 lives.

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Datapoint: Centene Partners With Cityblock on NY Value-Based Care

Centene Corp.’s New York Medicaid subsidiary Fidelis Care is partnering with Cityblock on a new value-based care program focused on enhancing community-based care in New York City and Long Island. Cityblock integrates primary care, behavioral health and social care services, offering 24/7 access to multidisciplinary care teams. Centene is the largest managed Medicaid insurer in New York, with 1,871,666 members.

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Datapoint: Elevance Under Fire for Louisiana Blues Deal

Lawmakers in Louisiana held a nearly eight-hour hearing on Feb. 5 with Blue Cross and Blue Shield of Louisiana officials over the insurer’s proposed sale to Elevance Health, Inc., Nola.com reported. Legislators noted that Elevance has had more than $26 million in regulatory fines in seven states, including Louisiana, for allegations such as failing to cover preventive services and failing to pay claims in a timely manner. The Louisiana Dept. of Insurance will hold a two-day hearing starting on Feb. 14 to determine whether the sale is in the best interests of the state and BCBS of Louisiana’s policyholders. The two Blues affiliates struck a deal last that would make Elevance the largest insurer in the state, with nearly 1.4 million members. As it stands, BCBS Louisiana currently ranks No. 2 behind UnitedHealthcare, with 1,057,776 lives.

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Datapoint: Medicaid Expansion Underway in North Carolina

Since North Carolina implemented Medicaid expansion under the Affordable Care Act on Dec. 1, 2023, more than 314,000 state residents have gained access to Medicaid as of Jan. 12, according to an enrollment update from the NC Dept. of Health and Human Services (NCDHHS). Approximately 273,000 of those beneficiaries were automatically enrolled after qualifying for Family Planning Medicaid, while another 41,000 signed up for coverage on their own. Moreover, about 25% of new enrollees reside in rural counties, while the other 75% live in urban areas, according to state data. North Carolina currently serves 2,326,474 Medicaid beneficiaries, according to the latest update to AIS’s Directory of Health Plans.

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Datapoint: Humana to Expand CenterWell Business

Humana Inc. announced on Jan. 30 plans to increase the number of CenterWell Senior Primary Care centers. The company will open centers in three new markets (Asheville, North Carolina, Baton Rouge, Louisiana, and New Orleans) and add centers in eight markets where it already operates. CenterWell Senior Primary Care and Conviva Care Center, both affiliates of Humana, delivered care to about 295,000 seniors in nearly 300 centers as of the end of last year. The planned expansion comes as Humana struggles in its main Medicare Advantage business line. The company announced on Jan. 25 that it expects to generate about $16 in adjusted earnings per share this year, down significantly from its previous guidance, due to higher-than-expected utilization from its MA members. Humana is currently the second-largest MA insurer nationally, with 5,859,064 members.

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