AIS’s Directory of Health Plans

Datapoint: Ohio Announces 2022 Medicaid Contract Awards

April 15, 2021

The state of Ohio on April 9 unveiled contract awards for its revamped Medicaid managed care program, with enrollment set to begin in January 2022. Four payers, CareSource, Centene Corp. Molina Healthcare and UnitedHealthcare are incumbents, while Humana Inc. and Anthem, Inc. will be new entrants. ProMedica’s Paramount Advantage, which currently enrolls 238,129 Ohio Medicaid members, was not selected to renew its contract. Ohio’s Medicaid program currently serves 2,749,113 lives, with 91.1% enrolled in a managed care plan.

The state of Ohio on April 9 unveiled contract awards for its revamped Medicaid managed care program, with enrollment set to begin in January 2022. Four payers, CareSource, Centene Corp. Molina Healthcare and UnitedHealthcare are incumbents, while Humana Inc. and Anthem, Inc. will be new entrants. ProMedica’s Paramount Advantage, which currently enrolls 238,129 Ohio Medicaid members, was not selected to renew its contract. Ohio’s Medicaid program currently serves 2,749,113 lives, with 91.1% enrolled in a managed care plan.

Source: AIS’s Directory of Health Plans

Datapoint: Biden Administration Pulls Work Requirements in Michigan, Wisconsin

April 13, 2021

The Biden administration last week nixed Medicaid work requirement approvals in two more states — Michigan and Wisconsin. The news comes just three weeks after Biden’s CMS pulled the controversial Medicaid reform in Arkansas and New Hampshire. Implementation of Wisconsin’s work requirement was already on hold as a result of the COVID-19 pandemic, while Michigan’s were blocked by a federal judge two months after they went into effect in January 2020. Wisconsin currently enrolls 1,108,482 Medicaid beneficiaries, to Michigan’s 2,663,882.

The Biden administration last week nixed Medicaid work requirement approvals in two more states — Michigan and Wisconsin. The news comes just three weeks after Biden’s CMS pulled the controversial Medicaid reform in Arkansas and New Hampshire. Implementation of Wisconsin’s work requirement was already on hold as a result of the COVID-19 pandemic, while Michigan’s were blocked by a federal judge two months after they went into effect in January 2020. Wisconsin currently enrolls 1,108,482 Medicaid beneficiaries, to Michigan’s 2,663,882.

Source: AIS’s Directory of Health Plans

Datapoint: MVP Health Care, University of Vermont to Launch Co-Branded MA Plan

April 12, 2021

MVP Health Care last week said it has partnered with The University of Vermont Health Network to launch a co-branded, physician-designed Medicare Advantage (MA) plan in New York and Vermont for the 2022 plan year. The plan will be patient-centered, and follow value-based care models in both states. As of March 2021, 3,610 people are enrolled in MVP’s MA plans in Vermont, while 60,061 are enrolled in New York.

MVP Health Care last week said it has partnered with The University of Vermont Health Network to launch a co-branded, physician-designed Medicare Advantage (MA) plan in New York and Vermont for the 2022 plan year. The plan will be patient-centered, and follow value-based care models in both states. As of March 2021, 3,610 people are enrolled in MVP’s MA plans in Vermont, while 60,061 are enrolled in New York.

Source: AIS’s Directory of Health Plans

Datapoint: Friday Health Plans Scores $160 Million Investment

April 8, 2021

Startup insurer Friday Health Plans last week said it has accepted $160 million in equity investments led by Vestar Capital Partners and Leadenhall Capital Partners, and will use the funds to expand into new territories and build its small group product line. As of the third quarter of 2020, the Denver-based insurer enrolled 14,338 members in Colorado, with 75.4% enrolled in an individual commercial risk-based plan. The company in February reported membership gains of 400%, to about 75,000 lives, following expansion if its Affordable Care Act exchange offerings to Nevada, New Mexico and Texas.

Startup insurer Friday Health Plans last week said it has accepted $160 million in equity investments led by Vestar Capital Partners and Leadenhall Capital Partners, and will use the funds to expand into new territories and build its small group product line. As of the third quarter of 2020, the Denver-based insurer enrolled 14,338 members in Colorado, with 75.4% enrolled in an individual commercial risk-based plan. The company in February reported membership gains of 400%, to about 75,000 lives, following expansion if its Affordable Care Act exchange offerings to Nevada, New Mexico and Texas.

Source: AIS’s Directory of Health Plans

Datapoint: Fallon Health to Exit Commercial Insurance Market

April 7, 2021

Worcester, Massachuetts-based insurer Fallon Health last week said it will “shift away” from most commercial product lines as of April 1, citing a renewed focus on Medicare and Medicaid. Fallon currently has 52,208 members in commercial risk-based plans, with 61% enrolled in a group risk product. The insurer also covers 72,500 lives through self-funded contracting arrangements.

Worcester, Massachuetts-based insurer Fallon Health last week said it will “shift away” from most commercial product lines as of April 1, citing a renewed focus on Medicare and Medicaid. Fallon currently has 52,208 members in commercial risk-based plans, with 61% enrolled in a group risk product. The insurer also covers 72,500 lives through self-funded contracting arrangements.

Source: AIS’s Directory of Health Plans