Florida’s Agency for Health Care Administration (AHCA) said it intended to award contracts to nine health plans that will provide Managed Medical Assistance (MMA) and Long-Term Care (LTC) programs to more than 3 million Floridians starting on Jan. 1, 2019. Big winners include Centene Corp., Humana Inc. and WellCare Health Plans, Inc., which each picked up additional regions in the Statewide Medicaid Managed Care (SMMC) program.
The new contracts will feature an enhanced plan package that includes a variety of elements focused on substance abuse treatment and mental health. The SMMC program will for the first time enable individuals with HIV/AIDS or a serious mental illness (SMI) to enroll in a specialty plan that is specifically designed to serve those diagnoses in every region and every county of the state.
Centene’s Sunshine Health picked up an additional region for a total of 10, Humana will go from serving five to 10 regions and WellCare’s Staywell Health Plan will go from eight to nine.
Anthem, however, will see its presence reduced by one region to a total of three. And UnitedHealthcare will go from serving four to two regions, which means the insurer could shed roughly half of its 258,000 members in Florida in 2019. Evercore ISI estimated that UnitedHealth stands to lose approximately $450 million in revenue from the downgrade, while WellCare will gain about $1.8 billion, Humana $1.5 billion and Centene $1.2 billion, with more modest revenue losses for Anthem.
The final contract awards left Molina Healthcare, Inc. out. The insurer currently serves approximately 350,000 Medicaid members in eight regions, which contributes about $1.5 billion in annualized revenue.