AIS’s Directory of Health Plans

Datapoint: Molina Scores Kentucky Medicaid Contract

December 9, 2019

Following a period of contract losses and service area reductions, Molina Healthcare last week scored a new managed Medicaid contract in Kentucky. The insurer will operate one of five plans selected to serve Kentucky’s 1.26 million Medicaid lives. Molina currently enrolls 2,783,150 Medicaid and CHIP members in 10 states and Puerto Rico.

Following a period of contract losses and service area reductions, Molina Healthcare last week scored a new managed Medicaid contract in Kentucky. The insurer will operate one of five plans selected to serve Kentucky’s 1.26 million Medicaid lives. Molina currently enrolls 2,783,150 Medicaid and CHIP members in 10 states and Puerto Rico.

Source: AIS’s Directory of Health Plans

Datapoint: Centene to Sell Illinois Medicaid Plan to CVS

December 5, 2019

In light of the Medicaid behemoth’s planned merger with WellCare Health Plans, Inc., Centene Corp. this week said it has agreed to sell its Illinois managed Medicaid business, IlliniCare, to CVS Health, the parent company of Aetna. IlliniCare currently operates the third-largest managed Medicaid plan in Illinois, with 345,994 members.

In light of the Medicaid behemoth’s planned merger with WellCare Health Plans, Inc., Centene Corp. this week said it has agreed to sell its Illinois managed Medicaid business, IlliniCare, to CVS Health, the parent company of Aetna. IlliniCare currently operates the third-largest managed Medicaid plan in Illinois, with 345,994 members.

Source: AIS’s Directory of Health Plans

Datapoint: North Carolina Suspends Medicaid Transformation

December 3, 2019

Due to a budget standoff between Republican legislators and the state’s Democratic governor, North Carolina has indefinitely delayed its upcoming Medicaid transformation, which would have shifted about 75% of the state’s 2,189,947 Medicaid beneficiaries from the fee-for-service system to managed care plans. The transition was initially slated to begin in February 2020, with Centene Corp., UnitedHealthcare and Blue Cross and Blue Shield of North Carolina, among others, set to participate.

Due to a budget standoff between Republican legislators and the state’s Democratic governor, North Carolina has indefinitely delayed its upcoming Medicaid transformation, which would have shifted about 75% of the state’s 2,189,947 Medicaid beneficiaries from the fee-for-service system to managed care plans. The transition was initially slated to begin in February 2020, with Centene Corp., UnitedHealthcare and Blue Cross and Blue Shield of North Carolina, among others, set to participate.

Source: AIS’s Directory of Health Plans

Datapoint: Insurers to Offer More D-SNPs in 2020

November 27, 2019

According to CMS’s 2020 “landscape” files, there will be 171 new net IDs for Special Needs Plans (SNPs) in 2020, and 97 of the new net plans are Dual Eligible Special Needs Plans (D-SNPs). D-SNPs have grown in popularity over the past few years, as they allow for more careful management of some of the most medically complex people in the country.

According to CMS’s 2020 “landscape” files, there will be 171 new net IDs for Special Needs Plans (SNPs) in 2020, and 97 of the new net plans are Dual Eligible Special Needs Plans (D-SNPs). D-SNPs have grown in popularity over the past few years, as they allow for more careful management of some of the most medically complex people in the country. There are currently 2,375,287 D-SNP members in the U.S., compared to 2,079,631 in the fourth quarter of 2017, a 14.2% increase.

Source: AIS’s Directory of Health Plans

Datapoint: Idaho Set to Begin Medicaid Expansion in January

November 26, 2019

CMS last week gave Idaho the go-ahead to implement its Medicaid expansion as planned in January 2020. The move comes following a successful ballot initiative in November 2018, though lawmakers added more restrictive provisions, such as a work requirement, that has yet to be approved by CMS.

CMS last week gave Idaho the go-ahead to implement its Medicaid expansion as planned in January 2020. The move comes following a successful ballot initiative in November 2018, though lawmakers added more restrictive provisions, such as a work requirement, that has yet to be approved by CMS. Idaho currently serves 278,919 Medicaid beneficiaries, and expansion could bring coverage to an additional 120,000 lives.

Source: AIS’s Directory of Health Plans