AIS’s Directory of Health Plans

Datapoint: Medicare Advantage Enrollment Reaches Just Under 24 Million in 2020

February 20, 2020

From February 2019 to February 2020, enrollment in Medicare Advantage plans grew 9.3%, to 23,992,220 lives. About 42% of the Medicare eligible population is now enrolled in an MA product.

From February 2019 to February 2020, enrollment in Medicare Advantage plans grew 9.3%, to 23,992,220 lives. About 42% of the Medicare eligible population is now enrolled in an MA product.

Source: AIS’s Directory of Health Plans

Datapoint: Pennsylvania Implements Medicaid Jobs Program

February 19, 2020

Pennsylvania has launched a new Medicaid initiative that helps connect enrollees to jobs and career services. New Medicaid sign-ups are asked if about their interest in “help finding a job, training programs, and opportunities to get a high school diploma or GED,” per the state’s press release. Unlike Medicaid work requirements, participation in Pennsylvania’s program is not mandatory, and does not affect Medicaid eligibility. The state currently serves 2,777,216 Medicaid beneficiaries, with 78.9% enrolled in managed care plans.

Pennsylvania has launched a new Medicaid initiative that helps connect enrollees to jobs and career services. New Medicaid sign-ups are asked if about their interest in “help finding a job, training programs, and opportunities to get a high school diploma or GED,” per the state’s press release. Unlike Medicaid work requirements, participation in Pennsylvania’s program is not mandatory, and does not affect Medicaid eligibility. The state currently serves 2,777,216 Medicaid beneficiaries, with 78.9% enrolled in managed care plans.

Source: AIS’s Directory of Health Plans

Datapoint: Molina Expects Less Exchange Income in 2020

February 18, 2020

Molina Healthcare in its fourth quarter 2019 earnings call said it expects to receive far less income from its Affordable Care Act exchange plans in 2020. The company is currently projecting that its exchange margins will top out at 4.9% this year, compared to 10.3% in 2019, which could add up to a difference of about $75 million.

Molina Healthcare in its fourth quarter 2019 earnings call said it expects to receive far less income from its Affordable Care Act exchange plans in 2020. The company is currently projecting that its exchange margins will top out at 4.9% this year, compared to 10.3% in 2019, which could add up to a difference of about $75 million. In the earnings call, executives cited increased competition for exchange membership, resulting in fewer sign-ups than anticipated, as one of the reasons for the unexpected drop. Molina currently serves 289,410 exchange members, as of the latest update to AIS’s Directory of Health Plans, representing about 9% of its total enrollment.

Source: AIS’s Directory of Health Plans

Datapoint: Geisinger to Swap MedImpact for PerformRx

February 17, 2020

Geisinger Health Plan has selected a new pharmacy benefits manager, and will switch to PerformRx in 2021 once its contract with MedImpact expires at the end of this year. Geisinger, currently the 10th-largest insurer in Pennsylvania, will continue to manage its own formulary.

Geisinger Health Plan has selected a new pharmacy benefits manager, and will switch to PerformRx in 2021 once its contract with MedImpact expires at the end of this year. Geisinger, currently the 10th-largest insurer in Pennsylvania, will continue to manage its own formulary. The insurer currently serves 528,669 lives, with 55.0% of members enrolled in a managed Medicaid or Medicare Advantage plan.

Source: AIS’s Directory of Health Plans

Michigan Scraps State-Run Medicaid Pharmacy Plan

February 13, 2020

Michigan Governor Gretchen Whitmer (D) last week said the state will not move forward with a plan to create a state-run, fee-for-service pharmacy benefit for Medicaid beneficiaries.

Michigan Governor Gretchen Whitmer (D) last week said the state will not move forward with a plan to create a state-run, fee-for-service pharmacy benefit for Medicaid beneficiaries. Instead, Michigan’s contracted managed care plans will continue to design their own pharmacy benefits, while working on a single preferred drug list for the Medicaid program, according to the Michigan Association of Health Plans. As of January 2020, Michigan contracts with 11 MCOs to serve its managed Medicaid program, which currently enrolls 1,734,324 people, with WellCare Health Plans, Inc., Molina Healthcare and UnitedHealthcare leading the pack in enrollment.

Source: AIS’s Directory of Health Plans