Datapoint

Datapoint: Horizon BCBSNJ Launches New Medicare Advantage Brand

September 17, 2020

Horizon Blue Cross Blue Shield of New Jersey and two Jersey-based health systems, Hackensack Meridian Health and RWJBarnabus Health (pending regulatory approval), are launching a new physician-led Medicare Advantage org in the state, Braven Health. The insurer will offer MA products in eight New Jersey counties for the 2021 plan year. Horizon BCBS is currently the fourth-largest MA insurer in New Jersey, with 23,245 members, or 5.0% of the state’s market.

Horizon Blue Cross Blue Shield of New Jersey and two Jersey-based health systems, Hackensack Meridian Health and RWJBarnabus Health (pending regulatory approval), are launching a new physician-led Medicare Advantage org in the state, Braven Health. The insurer will offer MA products in eight New Jersey counties for the 2021 plan year. Horizon BCBS is currently the fourth-largest MA insurer in New Jersey, with 23,245 members, or 5.0% of the state’s market.

Source: AIS’s Directory of Health Plans

Datapoint: Centene Plots Major 2021 Exchange Expansion

September 16, 2020

Centene Corp. last week said it will expand its Affordable Care Act exchange products to two new states (Michigan and New Mexico) and 400 new counties in its existing markets for the 2021 plan year. Centene is currently the largest exchange insurer in the U.S., with 2,187,894 members across 13 states. Nationally, Centene enrolls 19.1% of all exchange lives.

Centene Corp. last week said it will expand its Affordable Care Act exchange products to two new states (Michigan and New Mexico) and 400 new counties in its existing markets for the 2021 plan year. Centene is currently the largest exchange insurer in the U.S., with 2,187,894 members across 13 states. Nationally, Centene enrolls 19.1% of all exchange lives.

Source: AIS’s Directory of Health Plans

Datapoint: Anthem, Ascension to Launch Wisconsin Exchange Plans

September 15, 2020

Anthem, Inc. last week said it will launch co-branded health plans with Ascension Wisconsin on the Affordable Care Act exchanges for the 2021 plan year. Members will have in-network access to Ascension Wisconsin’s “24 hospital campuses, 110 care locations, and more than 1,300 physicians,” according to a press release. The plans will be offered in six southeast Wisconsin counties. Anthem does not have an ACA market presence in Wisconsin, where 179,731 are currently enrolled in exchange plans.

Anthem, Inc. last week said it will launch co-branded health plans with Ascension Wisconsin on the Affordable Care Act exchanges for the 2021 plan year. Members will have in-network access to Ascension Wisconsin’s “24 hospital campuses, 110 care locations, and more than 1,300 physicians,” according to a press release. The plans will be offered in six southeast Wisconsin counties. Anthem does not have an ACA market presence in Wisconsin, where 179,731 are currently enrolled in exchange plans.

Source: AIS’s Directory of Health Plans

Datapoint: Cigna to Expand Exchange Presence for 2021

September 14, 2020

Cigna Corp. last week said it will expand its Affordable Care Act exchange offerings to 80 new counties in 2021. The company in a press release said this represents a 27% growth in customer reach. Cigna said most of its 2021 offerings will offer no-cost virtual care, including behavioral health. Cigna currently holds the 11th-largest exchange market in the U.S., with 217,300 members across 10 states.

Cigna Corp. last week said it will expand its Affordable Care Act exchange offerings to 80 new counties in 2021. The company in a press release said this represents a 27% growth in customer reach. Cigna said most of its 2021 offerings will offer no-cost virtual care, including behavioral health. Cigna currently holds the 11th-largest exchange market in the U.S., with 217,300 members across 10 states.

Source: AIS’s Directory of Health Plans

Datapoint: Amarin Loses Vascepa Patent Appeal

September 10, 2020

A U.S. appeals court last week upheld a lower court ruling that definitively invalidates Amarin’s fish oil derivative drug Vascepa’s patents, meaning generic challengers can move forward. Amarin had blockbuster hopes for the heart drug, which the FDA approved in December 2019. Vascepa currently holds preferred status for 21% of all covered lives under the pharmacy benefit, growing to 44% with utilization management restrictions.

A U.S. appeals court last week upheld a lower court ruling that definitively invalidates Amarin’s fish oil derivative drug Vascepa’s patents, meaning generic challengers can move forward. Amarin had blockbuster hopes for the heart drug, which the FDA approved in December 2019. Vascepa currently holds preferred status for 21% of all covered lives under the pharmacy benefit, growing to 44% with utilization management restrictions.

SOURCE: MMIT Analytics, as of 9/9/20

Datapoint: Georgia Governor Seeks to Opt Out of Exchanges

September 9, 2020

Georgia Governor Brian Kemp (R) last week released a proposal to opt the entire state out of the federal Affordable Care Act exchanges, leaving residents to find their own commercial coverage. Kemp says this will lead to lower prices and a more competitive market, but critics worry it may lead to coverage gaps, and many people will unnecessarily lose their health care. 401,413 people are currently enrolled in exchange plans in Georgia, with Centene leading the pack at 65.9% market share.

Georgia Governor Brian Kemp (R) last week released a proposal to opt the entire state out of the federal Affordable Care Act exchanges, leaving residents to find their own commercial coverage. Kemp says this will lead to lower prices and a more competitive market, but critics worry it may lead to coverage gaps, and many people will unnecessarily lose their health care. 401,413 people are currently enrolled in exchange plans in Georgia, with Centene leading the pack at 65.9% market share.

Source: AIS’s Directory of Health Plans