AIS’s Directory of Health Plans

Datapoint: BCBS Michigan Selects OptumRx as New PBM

January 14, 2021

Blue Cross Blue Shield of Michigan last week said it has selected OptumRx as its new pharmacy benefits manager, ending its current partnership with Cigna Corp.’s Express Scripts. The switch will take effect in January 2022 for commercial members, and January 2023 for Medicare Advantage members. The Blues affiliate is the largest insurer in Michigan, serving 4,512,710 lives, or 44.4% of the state’s market.

Blue Cross Blue Shield of Michigan last week said it has selected OptumRx as its new pharmacy benefits manager, ending its current partnership with Cigna Corp.’s Express Scripts. The switch will take effect in January 2022 for commercial members, and January 2023 for Medicare Advantage members. The Blues affiliate is the largest insurer in Michigan, serving 4,512,710 lives, or 44.4% of the state’s market.

Source: AIS’s Directory of Health Plans

Datapoint: Molina Completes Magellan Complete Care Deal

January 13, 2021

Molina Healthcare last week completed its acquisition of Magellan Health’s Magellan Complete Care. Magellan’s specialty Medicaid products currently serve 145,432 members in Arizona, Florida and Virginia. The insurer also offers long-term care plans for seniors in Massachusetts and New York. The move expands Molina’s Medicaid footprint into Arizona and Virginia, and boosts its Florida business. Molina is currently the fifth-largest managed Medicaid insurer in the U.S., serving 3,017,109 lives.

Molina Healthcare last week completed its acquisition of Magellan Health’s Magellan Complete Care. Magellan’s specialty Medicaid products currently serve 145,432 members in Arizona, Florida and Virginia. The insurer also offers long-term care plans for seniors in Massachusetts and New York. The move expands Molina’s Medicaid footprint into Arizona and Virginia, and boosts its Florida business. Molina is currently the fifth-largest managed Medicaid insurer in the U.S., serving 3,017,109 lives.

Source: AIS’s Directory of Health Plans

Datapoint: CMS Approves Tennessee Medicaid Block Grant

January 12, 2021

With just days remaining in the Trump administration, CMS last week approved Tennessee’s waiver request to convert its traditional Medicaid funding to a block grant. Block grants, a conservative reform approach opposed by the incoming Biden administration, cap federal spending at a fixed dollar amount while allowing states more freedom in what services are covered under Medicaid, and who can apply for benefits. Tennessee currently serves 1,503,839 Medicaid beneficiaries. The state has not expanded Medicaid under the Affordable Care Act.

With just days remaining in the Trump administration, CMS last week approved Tennessee’s waiver request to convert its traditional Medicaid funding to a block grant. Block grants, a conservative reform approach opposed by the incoming Biden administration, cap federal spending at a fixed dollar amount while allowing states more freedom in what services are covered under Medicaid, and who can apply for benefits. Tennessee currently serves 1,503,839 Medicaid beneficiaries. The state has not expanded Medicaid under the Affordable Care Act.

Source: AIS’s Directory of Health Plans

Datapoint: Tufts, Harvard Pilgrim Complete Merger

January 11, 2021

Two of the largest insurers in New England, Tufts Health Plan and Harvard Pilgrim Health Care, have officially combined, according to a Jan. 4 press release. The new organization now serves 2,136,047 lives in five states, with 85.2% of members concentrated in Massachusetts. The two insurers announced their intent to merge in August 2019.

Two of the largest insurers in New England, Tufts Health Plan and Harvard Pilgrim Health Care, have officially combined, according to a Jan. 4 press release. The new organization now serves 2,136,047 lives in five states, with 85.2% of members concentrated in Massachusetts. The two insurers announced their intent to merge in August 2019.

Source: AIS’s Directory of Health Plans

Datapoint: Centene Strikes $2.2 Billion Deal for Magellan

January 7, 2021

Centene Corp. on Monday said it has entered an agreement to acquire Magellan Health, one of the largest independent providers of behavioral health services in the U.S. Its payer clients include Blue Cross and Blue Shield of Texas (5.9 million lives) Blue Shield of California (3.3 million lives) and Independence Blue Cross (1.8 million lives). Centene operates its own in-house behavioral health unit, Cenpatico, which serves most of its 20.0 million lives. The deal, valued at $2.2 billion, is expected to close in the second half of 2021, pending regulatory approval.

Centene Corp. on Monday said it has entered an agreement to acquire Magellan Health, one of the largest independent providers of behavioral health services in the U.S. Its payer clients include Blue Cross and Blue Shield of Texas (5.9 million lives) Blue Shield of California (3.3 million lives) and Independence Blue Cross (1.8 million lives). Centene operates its own in-house behavioral health unit, Cenpatico, which serves most of its 20.0 million lives. The deal, valued at $2.2 billion, is expected to close in the second half of 2021, pending regulatory approval.

Source: AIS’s Directory of Health Plans