AIS’s Directory of Health Plans

Datapoint: Court Ruling Clears Path for North Carolina Medicaid Transformation

February 25, 2021

A North Carolina superior court judge last week upheld an earlier ruling that dismissed requests to halt the state’s Medicaid managed care transformation, which has been in limbo since contracts were awarded in Feb. 2019. A statewide enrollment period will begin March 15 and run through mid-May. About 1.6 million of the state’s 2,418,324 Medicaid beneficiaries will be enrolled in plan offerings from AmeriHealth Caritas, Blue Cross and Blue Shield of North Carolina, Centene Corp. and UnitedHealthcare. The managed care plans will officially launch July 1 of this year.

A North Carolina superior court judge last week upheld an earlier ruling that dismissed requests to halt the state’s Medicaid managed care transformation, which has been in limbo since contracts were awarded in Feb. 2019. A statewide enrollment period will begin March 15 and run through mid-May. About 1.6 million of the state’s 2,418,324 Medicaid beneficiaries will be enrolled in plan offerings from AmeriHealth Caritas, Blue Cross and Blue Shield of North Carolina, Centene Corp. and UnitedHealthcare. The managed care plans will officially launch July 1 of this year.

Source: AIS’s Directory of Health Plans

Datapoint: Commonwealth Care Alliance to Expand Mass. Duals Demo

February 23, 2021

Boston-based community health org Commonwealth Care Alliance last week said it is expanding its One Care plan, a joint demonstration project with CMS that serves Medicare-Medicaid dual eligibles, into Berkshire County, Massachusetts. CCA currently serves 39,446 duals in Massachusetts, with 70.8% enrolled in One Care.

Boston-based community health org Commonwealth Care Alliance last week said it is expanding its One Care plan, a joint demonstration project with CMS that serves Medicare-Medicaid dual eligibles, into Berkshire County, Massachusetts. CCA currently serves 39,446 duals in Massachusetts, with 70.8% enrolled in One Care.

Source: AIS’s Directory of Health Plans

Datapoint: Aetna to Rejoin ACA Exchange Markets

February 18, 2021

CVS Health CEO Karen Lynch at the company’s Feb. 16 earnings call said Aetna will rejoin the Affordable Care Act exchange markets in January 2022. Aetna originally exited the exchanges in the 2018 plan year, citing financial losses in excess of $200 million. The ACA markets have stabilized in recent years, however, reaching 11.3 million members by the end of 2020, according to AIS’s Directory of Health Plans. Market leader Centene Corp. enrolls 19.4% of that cohort, with 2,200,062 lives.

CVS Health CEO Karen Lynch at the company’s Feb. 16 earnings call said Aetna will rejoin the Affordable Care Act exchange markets in January 2022. Aetna originally exited the exchanges in the 2018 plan year, citing financial losses in excess of $200 million. The ACA markets have stabilized in recent years, however, reaching 11.3 million members by the end of 2020, according to AIS’s Directory of Health Plans. Market leader Centene Corp. enrolls 19.4% of that cohort, with 2,200,062 lives.

Source: AIS’s Directory of Health Plans

Datapoint: Oscar Files for IPO

February 11, 2021

Insurance startup Oscar Health, Inc. on Feb. 5 filed a registration statement with the Securities and Exchange Commission — the next step in its proposed initial public offering. The insurer said it plans to use the ticker symbol “OSCR” on the New York Stock Exchange. Oscar currently enrolls 416,998 members, with 95.5% enrolled in individual plans.

Insurance startup Oscar Health, Inc. on Feb. 5 filed a registration statement with the Securities and Exchange Commission — the next step in its proposed initial public offering. The insurer said it plans to use the ticker symbol “OSCR” on the New York Stock Exchange. Oscar currently enrolls 416,998 members, with 95.5% enrolled in individual plans.

Source: AIS’s Directory of Health Plans

Datapoint: Anthem to Acquire InnovaCare’s Medicare Advantage, Medicaid Plans

February 8, 2021

Anthem, Inc. last week said it entered a deal to acquire InnovaCare Health’s MMM Holdings, the largest Medicare Advantage organization in Puerto Rico. InnovaCare currently enrolls 262,654 Medicare Advantage and dual eligible members, largely in Puerto Rico, though a handful of members reside in Florida. Anthem will also acquire InnovaCare’s managed Medicaid plan, which currently serves 302,415 beneficiaries in Puerto Rico.

Anthem, Inc. last week said it entered a deal to acquire InnovaCare Health’s MMM Holdings, the largest Medicare Advantage organization in Puerto Rico. InnovaCare currently enrolls 262,654 Medicare Advantage and dual eligible members, largely in Puerto Rico, though a handful of members reside in Florida. Anthem will also acquire InnovaCare’s managed Medicaid plan, which currently serves 302,415 beneficiaries in Puerto Rico.

Source: AIS’s Directory of Health Plans