Featured in Health Business Daily, July 18, 2017

Managed Medicaid Market Grew, Saw Healthy M&A Activity in 2016

Reprinted from MEDICARE ADVANTAGE NEWS, biweekly news and business strategies about Medicare Advantage plans, product design, marketing, enrollment, market expansions, CMS audits, and countless federal initiatives in MA and Medicaid managed care. Subscribe today!

By Lauren Flynn Kelly, Managing Editor
June 8, 2017Volume 23Issue 11

Medicaid has been the fastest-growing sector over the past few years, but changes in the political climate could threaten some of the investments made by insurers in this market. New plans, and plans new to managed Medicaid, serve 768,000 Medicaid members as of early 2017, or 1.7% of the total Medicaid market nationally, observes AIS Health Data. A net 2.6 million Medicaid covered lives shifted to these or other Medicaid plans since last year, due to acquisitions or transitioning between managed contracts and fee-for-service.

Major acquisitions in 2016 included Centene Corp.’s purchase of Health Net, Inc., which added some 1.9 million Medicaid members, mostly in California. Blue Shield of California, meanwhile, entered the Medicaid market with the acquisition of Care1st Health Plan, giving it 3.5% market share in California Medicaid.

Other moves included the acquisition of Medicaid assets from Advicare Corp. that gave WellCare Health Plans, Inc., roughly 32,500 Medicaid lives in South Carolina, and the purchase of Care1st of Arizona, which allowed WellCare to enter the Arizona Medicaid market.

WellCare on April 28 also completed the planned acquisition of Universal American Corp., which sold its Total Health Medicaid/SCHIP business in New York to Molina Healthcare, Inc. as part of its efforts to shed “non-core” businesses and sharpen its focus on Medicare Advantage.

The following table illustrates the top 25 managed Medicaid plans, which carry 36.87% of the national market. L.A. Care Health Plan, with nearly 2 million Medi-Cal enrollees, remains the largest health plan by enrollment.

Medicare Advantage News

Top 25 Managed Medicaid Plans, Ranked By 1Q17 Enrollment

Plan Name

Parent Company

State

Medicaid Enrollment

National Market Share

L.A. Care Medi-Cal

L.A. Care Health Plan

California

1,986,814

3.63%

Health Net Community Solutions

Centene Corporation

California

1,824,870

3.33%

CareSource Ohio

CareSource

Ohio

1,309,661

2.39%

New York State Catholic Health Plan

Fidelis Care, Inc.

New York

1,284,919

2.35%

Inland Empire Health Plan Medi-Cal

Inland Empire Health Plan

California

1,235,336

2.26%

Healthfirst PHSP

Healthfirst

New York

947,926

1.73%

Superior HealthPlan

Centene Corporation

Texas

930,051

1.70%

Horizon NJ Health

Horizon Blue Cross Blue Shield

New Jersey

813,540

1.49%

Anthem Blue Cross of California Medi-Cal

Anthem, Inc.

California

796,589

1.46%

CalOptima Medi-Cal

CalOptima

California

781,733

1.43%

Amerigroup Texas

Anthem, Inc.

Texas

765,287

1.40%

Molina Healthcare of Washington

Molina Healthcare, Inc.

Washington

722,451

1.32%

Staywell Health Plan

WellCare Health Plans, Inc.

Florida

675,980

1.24%

WellCare of Georgia

WellCare Health Plans, Inc.

Georgia

587,904

1.07%

Partnership Health Plan of CA Medi-Cal

Partnership HealthPlan of California

California

571,581

1.04%

WellCare of Kentucky

WellCare Health Plans, Inc.

Kentucky

536,724

0.98%

BlueCare

BlueCross BlueShield of Tennessee

Tennessee

527,385

0.96%

Sunshine Health

Centene Corporation

Florida

513,201

0.94%

UnitedHealthcare Community Plan

UnitedHealthcare

Arizona

508,291

0.93%

UnitedHealthcare Community Plan

UnitedHealthcare

New York

505,729

0.92%

Meridian Health Plan of Michigan

Meridian Health Plan of Michigan

Michigan

480,756

0.88%

Molina Healthcare Medi-Cal

Molina Healthcare, Inc.

California

478,507

0.87%

Louisiana Healthcare Connections

Centene Corporation

Louisiana

478,414

0.87%

UnitedHealthcare Community Plan for Families

UnitedHealthcare

Tennessee

458,957

0.84%

Anthem Blue Cross and Blue Shield of Indiana

Anthem, Inc.

Indiana

449,924

0.82%

Total Managed Medicaid Enrollment: 54,719,991

SOURCE: MMM, Medicare and Medicaid Market Data, AIS’s newly revamped interactive database and newsfeed on the public-sector markets. Visit https://aishealthdata.com/mmm for more information and a free demo.


AIS’s Medicare and Medicaid Market Data is an online subscription database with up-to-date information on enrollment, premium rates, benefit designs and strategies of Medicare Advantage plans, Part D plans, Medicaid HMOs and other public-sector health plans. Learn more and check out a free interactive demo of the database!

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