AIS’s Directory of Health Plans

Datapoint: Sanford Health, UnityPoint Call Off Merger

November 18, 2019

Two large Midwest health systems, Sanford Health and UnityPoint Health, have called off their $11 billion merger, according to a statement from Sanford’s CEO. In addition to operating 76 hospitals between them, both companies have stakes in the health insurance market. Sanford Health’s insurance products enroll 190,899 members in the upper Midwest, while UnityPoint’s Medicare Advantage partnership with HealthPartners currently serves 1,268 lives.

Two large Midwest health systems, Sanford Health and UnityPoint Health, have called off their $11 billion merger, according to a statement from Sanford’s CEO. In addition to operating 76 hospitals between them, both companies have stakes in the health insurance market. Sanford Health’s insurance products enroll 190,899 members in the upper Midwest, while UnityPoint’s Medicare Advantage partnership with HealthPartners currently serves 1,268 lives.

Source: AIS’s Directory of Health Plans

Datapoint: ACA Sign-Ups Down 48% in First Week

November 14, 2019

Sign-ups for Affordable Care Act exchange plans were down 47.6% to 177,082 people in the first week of open enrollment, according to data from CMS. CMS said this may have been due to technical issues with the consumer website. Currently, 11,127,222 people are enrolled in exchange plans nationwide.

Sign-ups for Affordable Care Act exchange plans were down 47.6% to 177,082 people in the first week of open enrollment, according to data from CMS. CMS said this may have been due to technical issues with the consumer website. Currently, 11,127,222 people are enrolled in exchange plans nationwide.

Source: AIS’s Directory of Health Plans

Datapoint: CMS Approves DC Medicaid Waiver

November 13, 2019

CMS last week approved a first-of-its-kind Section 1115 Medicaid waiver in the District of Columbia, which will expand behavioral health access to D.C. Medicaid eligibles residing in inpatient mental health facilities, as well as those suffering from serious mental illnesses or emotional disturbances who may be chronically homeless.

CMS last week approved a first-of-its-kind Section 1115 Medicaid waiver in the District of Columbia, which will expand behavioral health access to D.C. Medicaid eligibles residing in inpatient mental health facilities, as well as those suffering from serious mental illnesses or emotional disturbances who may be chronically homeless. The District currently serves 273,352 Medicaid beneficiaries, with 77.4% enrolled in managed care plans.

Source: AIS’s Directory of Health Plans

Datapoint: Georgia Submits Plan to Transform Medicaid

November 12, 2019

Georgia Governor Brian Kemp (R) on Oct. 31 unveiled a plan that would expand Medicaid in the state —in tandem with a work requirement. The expansion would qualify uninsured adults living at or below the federal poverty line for Medicaid benefits if they participate in 80 or more hours per month of work, volunteering, school or another qualifying activity. The proposal, which must be approved by CMS, also includes plans to set up a reinsurance program and give the state control of Affordable Care Act subsidies. Georgia currently serves 2,024,458 Medicaid beneficiaries, with 71.0% enrolled in managed care plans.

Georgia Governor Brian Kemp (R) on Oct. 31 unveiled a plan that would expand Medicaid in the state —in tandem with a work requirement. The expansion would qualify uninsured adults living at or below the federal poverty line for Medicaid benefits if they participate in 80 or more hours per month of work, volunteering, school or another qualifying activity. The proposal, which must be approved by CMS, also includes plans to set up a reinsurance program and give the state control of Affordable Care Act subsidies. Georgia currently serves 2,024,458 Medicaid beneficiaries, with 71.0% enrolled in managed care plans.

Source: AIS’s Directory of Health Plans

Datapoint: Cigna, Molina Suffer Medicaid Contract Losses in Texas

November 7, 2019

The Texas Health and Human Services Commission last week awarded three-year contracts for the state’s STAR+PLUS Medicaid program, which combines managed Medicaid with long-term services and supports. Most incumbents were able to keep their spots, save Cigna Corp., which was not selected, and Molina Healthcare, which lost several of its service areas. Cigna currently serves 48,498 STAR+PLUS members to Molina’s 85,308. Overall, the STAR+PLUS program serves 524,032 members, 13.6% of the managed Medicaid population in Texas.

The Texas Health and Human Services Commission last week awarded three-year contracts for the state’s STAR+PLUS Medicaid program, which combines managed Medicaid with long-term services and supports. Most incumbents were able to keep their spots, save Cigna Corp., which was not selected, and Molina Healthcare, which lost several of its service areas. Cigna currently serves 48,498 STAR+PLUS members to Molina’s 85,308. Overall, the STAR+PLUS program serves 524,032 members, 13.6% of the managed Medicaid population in Texas.

Source: AIS’s Directory of Health Plans