AIS Health’s data team on Sept. 23 updated the Directory of Health Plans (DHP) subscriber dashboard and in-app spreadsheets with new enrollment numbers. This data primarily reflects second-quarter 2021 status but includes third-quarter 2021 lives for Medicare Advantage (MA) products and some Medicaid figures, based on availability at the state level.
As of this update, the Medicaid sector continued its COVID-fueled rise, gaining more than 2.8 million managed care lives from the first quarter of 2021, while fee-for-service Medicaid inched down 77,000 members as states continue efforts to move toward managed care.
The most notable change in the Medicaid space since the previous update resulted from the implementation of North Carolina’s long-awaited managed Medicaid program, with contracted insurers Blue Cross and Blue Shield of North Carolina, AmeriHealth Caritas Family of Companies, UnitedHealthcare and Centene Corp. (alongside its WellCare subsidiary). The plans enroll more than 1.4 million members, reducing membership for Community Care of North Carolina (the state’s fee-for-service facilitator) by roughly that number.
Centene also took over WellCare Health Plans’ Medicaid contract in Georgia as part of the companies’ consolidation, adding about 436,000 new members. While WellCare was acquired by Centene in January 2020, the two insurers continue to be represented as separate entities linked by a parent ID in DHP, as Centene is maintaining the WellCare brand in MA and certain Medicaid states, including North Carolina.
Meanwhile, the public health insurance exchange market increased by more than 255,000 members from the first quarter, as the federal and state special election period continued. Full membership numbers won’t be available until the third-quarter update at the earliest, since the program was extended through mid-August. Centene rebounded from its exchange membership loss last quarter, adding about 140,000 new members due to new sign-ups in Florida, Texas and Georgia. CareSource, Molina and Bright Health also made decent gains from last quarter.
Commercial risk group enrollment was down roughly 388,000 across all insurers from the first quarter, the bulk of which can be attributed to Blue Shield of California, which lost nearly 280,000 group members. However, this could be attributed to an error in their state department of insurance filings — researchers are looking closely at the decrease. In the same vein, SIMNSA Health Plan gained nearly 40,000 members, but it appears that the insurer may have filed its first-quarter 2021 using inaccurate data, and the increase represents a correction. Most other gains and decreases in commercial group risk were modest.
MA plans gained a little over 211,000 members since last quarter, 61,000 of which can be attributed to UnitedHealthcare, the largest MA insurer nationally, while No. 2 Humana gained nearly 34,000 members.
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. Current subscribers can contact firstname.lastname@example.org 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.