AIS’s Directory of Health Plans

An advocacy group is working to bring Medicaid expansion to the ballot in Florida’s 2026 elections, according to a Feb. 1 report in the Tallahassee Democrat. Organizers will need to collect nearly 1 million signatures, but expansion initiatives have already been successful in seven other states. Florida currently serves 5.09 million Medicaid beneficiaries, with 73% enrolled in managed care plans. More than 1.4 million people could become eligible for Medicaid under expansion, the campaign manager for the group, Florida Decides Healthcare, said at a press conference.

Blue Shield of California’s Promise Health Plan is launching a no-cost service to help its Medicaid members obtain a GED. Offered via GEDWorks’ online platform, members can access study materials in English and Spanish, one-on-one tutoring, practice tests and personal advisors. "Lack of education is a barrier for many people trying to achieve economic, physical, and mental wellbeing," Jennifer Schirmer, vice president of Blue Shield Promise, said in a statement. "Removing that barrier can change lives. Education not only opens the door to employment opportunities, it gives people the tools to better understand how to be an active partner in their health.” The insurer currently serves 149,580 California Medicaid beneficiaries.

Medical Mutual on Jan. 29 unveiled a deal to acquire Toledo, Ohio-based insurer Paramount Health. Paramount is a subsidiary of ProMedica, a system of 11 hospitals that serves Ohio and Michigan. “As ProMedica has further sharpened its focus on core health system operations, we embarked on a thoughtful process to transition ownership of our Paramount health insurance business,” ProMedica CEO Arturo Polizzi said in a statement. “We were hopeful we could identify a potential new owner with a similar mission and commitment to community, and we found those qualities in Medical Mutual.” Paramount currently serves 72,303 health plan members in Ohio, with an additional 3,020 members in Michigan. Medical Mutual, meanwhile, is the fourth-largest insurer in the state, with 1,010,088 members. Financial terms of the deal, which is expected to close in the second quarter of 2024, were not disclosed.

Medicaid insurer CareSource this month unveiled its Rural Access Advancement Program, a “lifeline” that provides emergency funding to rural Georgia hospitals in danger of closing due to cash flow issues. “The Rural Access Advancement Program will assist rural hospitals and hospital-owned skilled nursing home facilities in rural areas in times of critical cash deficits that might otherwise lead to service limitations or hospital closures,” the insurer wrote in a press release. “Once the facility has stabilized, the funds will be repaid and reinvested into the program.” CareSource currently serves 513,043 Medicaid members in Georgia.

Affordable Care Act marketplace enrollment has climbed to 21.3 million during the annual open enrollment period, which ended in most states after Jan. 15 but continues through Jan. 31 in four states and Washington, D.C. Even with more signups to be counted, however, marketplace enrollment has climbed “nearly 5 million people higher” than the total number tallied during last year’s open enrollment. Biden administration officials credited the availability of enhanced subsidies for marketplace enrollees, which were first enacted under the American Rescue Plan Act and extended through 2025 by the Inflation Reduction Act, and increased investment in Navigator programs that help consumers find the right coverage. There were 17,722,797 exchange enrollees as of the third quarter of 2023, according to AIS’s Directory of Health Plans.

The West Virginia Department of Human Services last week selected Highmark Health to serve the state’s managed Medicaid program. The 4-year contract is slated to begin July 1. “We appreciate the trust the state has shown in us through this selection,” Jason Landers, West Virginia president of Highmark Health Options, said in a statement. “It's an honor and privilege to serve all West Virginians, and a responsibility we don’t take lightly. We are excited to provide a Blue Cross Blue Shield insurance plan that will make the state proud.” West Virginia’s Medicaid program is also served by CVS Health’s Aetna, The Health Plan of West Virginia and Elevance Health’s UniCare. Of the state’s 513,000 Medicaid beneficiaries, 84% are enrolled in managed care plans.

Blue Cross and Blue Shield of North Carolina last week completed its deal to purchase all North Carolina locations of FastMed, a chain of urgent care clinics that also offer primary care, telehealth and preventive care, for an undisclosed sum. The deal includes 55 FastMed locations. “With approximately half of FastMed’s clinics located in rural areas of our state with limited access to health care resources, I believe this is a vital investment in North Carolina,” Tunde Sotunde, Blue Cross NC’s CEO, said in a statement. The Blues affiliate is the largest insurer in its home state, serving 2,343,259 members.

New Hampshire’s Department of Health and Human Services last week unveiled contract awards for state’s managed Medicaid program. All three of the selected MCOs — AmeriHealth Caritas, Centene Corp.’s Granite State Health Plan and Boston Medical Center’s Well Sense Health Plan — are incumbents to the program. The 5-year contracts are slated to begin Sept. 1, 2024, and emphasize “a primary care and prevention model of access to services through a more meaningful and holistic role of providers in the delivery of managed care services,” according to the state. New Hampshire currently serves 163,715 Medicaid beneficiaries, with more than 99% enrolled in managed care plans.

Elevance Health is partnering with mobile carriers Verizon, Samsung, AT&T and T-Mobile to provide select Medicaid members with smartphones. The devices will include unlimited data, talk and texting services, and come preloaded with digital health care tools. "The lack of sufficient internet connectivity and technology access remains a significant barrier for many – increasing health inequities," Kurt Small, President of Elevance Health’s Medicaid business, said in a statement. “This program aims to directly address this challenge and helps improve the health of the people we serve.” Elevance said the program will launch in multiple states later this year, though it did not disclose which states. Elevance is currently the second-largest managed Medicaid insurer in the U.S., behind Centene Corp., with 8,853,470 members.

Centene Corp. agreed to pay the state of South Carolina nearly $25.9 million to settle allegations it overcharged the state’s Medicaid program for pharmacy services. Centene did not admit any wrongdoing in the settlement, which South Carolina Attorney General Alan Wilson announced in a Dec. 29 press release. Centene has settled similar allegations with several other state Medicaid programs and said in 2021 that it had set aside $1.25 billion to settle such lawsuits. Centene is currently the second-largest Medicaid managed care insurer in South Carolina, serving 215,477 lives.