Medicare and Medicaid

Datapoint: Managed Medicaid Plans Enroll Nearly Three-Quarters of Overall Market

March 16, 2020

Of the 73.7 million Medicaid beneficiaries in the U.S., 73.1% are currently enrolled in a managed care plan. Just 12 state Medicaid programs remain entirely fee-for-service.

Of the 73.7 million Medicaid beneficiaries in the U.S., 73.1% are currently enrolled in a managed care plan. Just 12 state Medicaid programs remain entirely fee-for-service.

Source: AIS’s Directory of Health Plans

Successful AEP Saw Medicare Advantage Membership Grow 9.4% From 2019 to 2020

March 13, 2020

More than 2 million people selected a Medicare Advantage plan from February 2019 to February 2020, bringing the total MA population to about 24 million medical lives, according to AIS Health’s analysis of data from the 2020 Medicare Annual Election Period. This year’s results continue the trend of steady gains in the MA market, particularly as more seniors are attracted to new supplemental benefits offered by MA plans.

by Carina Belles

More than 2 million people selected a Medicare Advantage plan from February 2019 to February 2020, bringing the total MA population to about 24 million medical lives, according to AIS Health’s analysis of data from the 2020 Medicare Annual Election Period. This year’s results continue the trend of steady gains in the MA market, particularly as more seniors are attracted to new supplemental benefits offered by MA plans. Membership increases were heavily concentrated among the top MA payers, with about 66% of all new enrollees choosing an offering from UnitedHealthcare, Humana Inc. or CVS Health Corp.’s Aetna. See a complete breakdown of the top 10 payers’ year-over-year results below. Overall growth was so widespread that no states saw a decline in MA enrollment, with four (Delaware, New Hampshire, Nebraska and Vermont) seeing increases of more than 20% (see map below).

NOTE: Per AIS’s research methodology, above analysis does not include about 420,000 lives enrolled in CMS’s Financial Alignment Initiative demonstration plans for Medicare-Medicaid Dual Eligibles.

SOURCE: DHP, AIS’s Directory of Health Plans. Visit https://aishealthdata.com/dhp for more information.

Datapoint: Mutual of Omaha to Sell MA Business

March 11, 2020

After just two years of offering Medicare Advantage (MA) products, Mutual of Omaha recently announced plans to sell its MA business to Essence Healthcare, a sister company of Lumeris. The deal stands to boost Essence’s membership by about 3.8%, to 66,700 lives.

After just two years of offering Medicare Advantage (MA) products, Mutual of Omaha recently announced plans to sell its MA business to Essence Healthcare, a sister company of Lumeris. The deal stands to boost Essence’s membership by about 3.8%, to 66,700 lives.

Source: AIS’s Directory of Health Plans

Datapoint: Michigan’s Medicaid Work Requirements Struck Down in Court

March 10, 2020

A federal judge last week tossed out Michigan’s newly enacted Medicaid work requirement provision, regulations that would have impacted the state’s expansion population. At the time of the ruling, Michigan was already in the process of notifying about 80,000 enrollees that failed to meet January’s reporting requirements that they were at risk of losing their health coverage, according to the Associated Press. The state currently serves more than 2.3 million Medicaid beneficiaries, with about 29% enrolled via Medicaid expansion. Michigan is now the fourth state to have its Medicaid requirements struck down in court, joining Arkansas, Kentucky and New Hampshire.

A federal judge last week tossed out Michigan’s newly enacted Medicaid work requirement provision, regulations that would have impacted the state’s expansion population. At the time of the ruling, Michigan was already in the process of notifying about 80,000 enrollees that failed to meet January’s reporting requirements that they were at risk of losing their health coverage, according to the Associated Press. The state currently serves more than 2.3 million Medicaid beneficiaries, with about 29% enrolled via Medicaid expansion. Michigan is now the fourth state to have its Medicaid requirements struck down in court, joining Arkansas, Kentucky and New Hampshire.

Source: AIS’s Directory of Health Plans

Major Insurers Report Strong Earnings and MA Membership Growth

March 10, 2020

The majority of publicly traded insurers reporting fourth-quarter and full-year 2019 earnings over the last month identified government business as a significant earnings contributor, with momentum from the recent Medicare Advantage open enrollment period carrying that growth into 2020.

Reporting its first full year of earnings with Aetna Inc., CVS Health Corp. on Feb. 12 said that acquisition was the main driver of consolidated growth of 32% to nearly $256.8 billion. Total revenues in the company’s Health Care Benefits segment continued to benefit from strong membership in government products, said Eva Boratto, CVS Health chief financial officer, during a conference call to discuss recent earnings.

By Lauren Flynn Kelly

The majority of publicly traded insurers reporting fourth-quarter and full-year 2019 earnings over the last month identified government business as a significant earnings contributor, with momentum from the recent Medicare Advantage open enrollment period carrying that growth into 2020.

Reporting its first full year of earnings with Aetna Inc., CVS Health Corp. on Feb. 12 said that acquisition was the main driver of consolidated growth of 32% to nearly $256.8 billion. Total revenues in the company’s Health Care Benefits segment continued to benefit from strong membership in government products, said Eva Boratto, CVS Health chief financial officer, during a conference call to discuss recent earnings.

During a Feb. 6 earnings call, Cigna Corp. President and CEO David Cordani said the company is focused on growing its MA business in geographies where its commercial business “has deep ties in delivery systems.” For 2020, Cigna anticipates MA membership growth of 13% to 16%, contributing to earnings growth of 11% to 13% in its Integrated Medical segment.

Reporting earnings on Feb. 5, Humana Inc. touted strong membership gains in both MA and Medicaid last year and said 2019 was its most successful year for growth in individual MA enrollment, which climbed 17% to 3.59 million members as of Dec. 31.

Fresh off closing its acquisition of WellCare Health Plans, Inc., Centene Corp. on Feb. 4 reported fourth-quarter 2019 revenues of $18.9 billion, up 14% from the prior-year quarter. That increase was primarily due to growth in its Affordable Care Act marketplace business, but it was partially offset by the health insurer fee moratorium in 2019, said CFO Jeff Schwaneke.

As Centene continued to grow leadership positions in the Medicaid and exchange markets last year, the insurer lost approximately 3% of its Medicare membership but is “focused on addressing the underlying drivers of this underperformance,” added President and CEO Michael Neidorff during a Feb. 4 earnings call.

During a Jan. 29 earnings call, Anthem, Inc. President and CEO Gail Boudreaux said the insurer’s government segment continues to be the “faster-growing portion” of the business and that MA enrollment increased by more than 20% in 2019. That momentum is carrying into 2020.

Datapoint: Oscar Sees First MA Enrollment Results

March 3, 2020

Health insurance startup Oscar Health gained 1,469 enrollees in the most recent Medicare Annual Election Period, following product launches in New York and Texas. This is Oscar’s first year offering Medicare Advantage products.

Health insurance startup Oscar Health gained 1,469 enrollees in the most recent Medicare Annual Election Period, following product launches in New York and Texas. This is Oscar’s first year offering Medicare Advantage products.

Source: AIS’s Directory of Health Plans