AIS’s Directory of Health Plans

Datapoint: Medicaid Enrollment Grows More Than 10% Year-Over-Year

April 5, 2021

From March 2020 to March 2021, the total U.S. Medicaid population (including managed care plans and traditional fee-for-service coverage) grew 11.1% to 81.9 million lives, according to the latest update to AIS’s Directory of Health Plans. This growth is largely a result of the COVID-19 pandemic, though one state, Idaho, implemented Medicaid expansion in January 2020.

From March 2020 to March 2021, the total U.S. Medicaid population (including managed care plans and traditional fee-for-service coverage) grew 11.1% to 81.9 million lives, according to the latest update to AIS’s Directory of Health Plans. This growth is largely a result of the COVID-19 pandemic, though one state, Idaho, implemented Medicaid expansion in January 2020.

Source: AIS’s Directory of Health Plans

Datapoint: Blues Plans Enroll Half of Group Risk Market

April 1, 2021

Nearly half (47.3%) of the national group commercial risk insurance market is enrolled in a Blue Cross and Blue Shield affiliate plan. Of the 26.2 million group risk lives enrolled in a Blues plan, 20.5% are Anthem, Inc. members.

Nearly half (47.3%) of the national group commercial risk insurance market is enrolled in a Blue Cross and Blue Shield affiliate plan. Of the 26.2 million group risk lives enrolled in a Blues plan, 20.5% are Anthem, Inc. members.

Source: AIS’s Directory of Health Plans

Datapoint: Anthem to Acquire Senior Home Management Company

March 30, 2021

Anthem, Inc. last week unveiled plans to acquire myNEXUS, Inc., “a comprehensive home-based nursing management company for payors,” the insurer said in a press release. The myNEXUS platform is a provider-facing service, and allows for streamlined authorization of in-home nursing care. Anthem said myNEXUS currently serves 1.7 million Medicare Advantage (MA) members across 20 states. Anthem is currently the fifth-largest MA payer in the U.S., with 1,493,268 enrollees, a 16% increase from last year.

Anthem, Inc. last week unveiled plans to acquire myNEXUS, Inc., “a comprehensive home-based nursing management company for payors,” the insurer said in a press release. The myNEXUS platform is a provider-facing service, and allows for streamlined authorization of in-home nursing care. Anthem said myNEXUS currently serves 1.7 million Medicare Advantage (MA) members across 20 states. Anthem is currently the fifth-largest MA payer in the U.S., with 1,493,268 enrollees, a 16% increase from last year.

Source: AIS’s Directory of Health Plans

Datapoint: Hawaii Announces New Medicaid Contract Awards

March 25, 2021

After a year-long delay spurred by the COVID-19 pandemic, Hawaii last week awarded new state Medicaid contracts for its managed care program, MEDQUEST. All of the selected MCOs are incumbents. AlohaCare, Hawaii Medical Service Association, Centene Corp.’s ‘Ohana Health Plan and UnitedHealthcare were awarded statewide contracts, while Kaiser Foundation Health Plan’s new contract covers Oahu and Maui only. MEDQUEST currently serves 378,100 lives, a 12.8% increase from March 2020.

After a year-long delay spurred by the COVID-19 pandemic, Hawaii last week awarded new state Medicaid contracts for its managed care program, MEDQUEST. All of the selected MCOs are incumbents. AlohaCare, Hawaii Medical Service Association, Centene Corp.’s ‘Ohana Health Plan and UnitedHealthcare were awarded statewide contracts, while Kaiser Foundation Health Plan’s new contract covers Oahu and Maui only. MEDQUEST currently serves 378,100 lives, a 12.8% increase from March 2020.

Source: AIS’s Directory of Health Plans

Datapoint: Biden Admin Nixes Work Requirements in Two States

March 24, 2021

The Biden administration last week quietly rescinded Medicaid work requirement approvals in Arkansas and New Hampshire, according to letters sent by CMS to the states. The U.S. Supreme Court was supposed to hear oral arguments related to the controversial reforms touted by the Trump administration next week, but recently removed the hearing from its docket, suggesting that previous rulings striking down work requirements could stand. Arkansas, which currently serves 853,216 Medicaid beneficiaries, was the only state to ever fully implement a work requirement. About 18,000 people lost coverage over a six-month period before a D.C. district court judge blocked the rule in March 2019.

The Biden administration last week quietly rescinded Medicaid work requirement approvals in Arkansas and New Hampshire, according to letters sent by CMS to the states. The U.S. Supreme Court was supposed to hear oral arguments related to the controversial reforms touted by the Trump administration next week, but recently removed the hearing from its docket, suggesting that previous rulings striking down work requirements could stand. Arkansas, which currently serves 853,216 Medicaid beneficiaries, was the only state to ever fully implement a work requirement. About 18,000 people lost coverage over a six-month period before a D.C. district court judge blocked the rule in March 2019.

Source: AIS’s Directory of Health Plans