AIS’s Directory of Health Plans

Datapoint: Capital BlueCross to Form Strategic Partnership With WellSpan Health

May 7, 2019

Pennsylvania-based Capital BlueCross said it has entered a long-term agreement to form a strategic partnership with WellSpan Health, an integrated system of eight hospitals and more than 170 patient care facilities throughout Pennsylvania and Maryland. The two entities plan to launch new Medicare Advantage products, and will aim to more closely coordinate care delivery, enhancing benefits and creating new digital health strategies. Financial details of the arrangement were not disclosed. Capital BlueCross currently enrolls 696,572 lives in Pennsylvania, with 43.2% of members enrolled in risk-based commercial products.

Pennsylvania-based Capital BlueCross said it has entered a long-term agreement to form a strategic partnership with WellSpan Health, an integrated system of eight hospitals and more than 170 patient care facilities throughout Pennsylvania and Maryland. The two entities plan to launch new Medicare Advantage products, and will aim to more closely coordinate care delivery, enhancing benefits and creating new digital health strategies. Financial details of the arrangement were not disclosed. Capital BlueCross currently enrolls 696,572 lives in Pennsylvania, with 43.2% of members enrolled in risk-based commercial products.

Source: AIS’s Directory of Health Plans

Datapoint: Anthem Makes MA Gains Addressing Social Determinants of Health

May 2, 2019

Anthem, Inc. experienced a 13.7% gain in Medicare Advantage enrollment from the fourth quarter of 2018 to the first quarter of 2019, according to the latest update to AIS’s Directory of Health Plans. Anthem CEO Gail Boudreaux in a recent earnings call pointed to the insurer’s new benefits package, which addresses social determinants of health, such as food insecurity, lack of transportation and the need for in-home care services, as the driving force behind this boost. Anthem currently enrolls 1,099,100 MA lives nationwide.

Anthem, Inc. experienced a 13.7% gain in Medicare Advantage enrollment from the fourth quarter of 2018 to the first quarter of 2019, according to the latest update to AIS’s Directory of Health Plans. Anthem CEO Gail Boudreaux in a recent earnings call pointed to the insurer’s new benefits package, which addresses social determinants of health, such as food insecurity, lack of transportation and the need for in-home care services, as the driving force behind this boost. Anthem currently enrolls 1,099,100 MA lives nationwide.

Source: AIS’s Directory of Health Plans

Datapoint: Fallon Health Offers New Financial Incentives for Employer-Sponsored Plans

May 1, 2019

Massachusetts-based insurer Fallon Health this month unveiled two new incentive programs for its employer group segment. One program offers a premium credit to employers if their group medical costs are lower than 89% of the paid premium, while the other offers a $5,000 credit to new employer group customers if Fallon fails to meet certain expectations during onboarding. Fallon currently enrolls 36,540 large group members and 7,307 small group members, with about 65,000 other members enrolled in self-funded arrangements.

Massachusetts-based insurer Fallon Health this month unveiled two new incentive programs for its employer group segment. One program offers a premium credit to employers if their group medical costs are lower than 89% of the paid premium, while the other offers a $5,000 credit to new employer group customers if Fallon fails to meet certain expectations during onboarding. Fallon currently enrolls 36,540 large group members and 7,307 small group members, with about 65,000 other members enrolled in self-funded arrangements.

Source: AIS’s Directory of Health Plans

Datapoint: CMS Announces New Care Model for Dual Eligibles

April 29, 2019

CMS last week announced a new model for states to test integrated care delivery for Medicare-Medicaid dual eligibles. The agency’s letter to state Medicaid directors urges states to test both capitated financial alignment with health plans and a fee-for-service model, similar to its original duals demonstrations. CMS is also giving states the option to design their own care model. Eleven states are currently running CMS-backed demonstrations for dual eligibles, with 419,450 total members. There are currently about 2.94 million people enrolled in duals plans nationwide.

CMS last week announced a new model for states to test integrated care delivery for Medicare-Medicaid dual eligibles. The agency’s letter to state Medicaid directors urges states to test both capitated financial alignment with health plans and a fee-for-service model, similar to its original duals demonstrations. CMS is also giving states the option to design their own care model. Eleven states are currently running CMS-backed demonstrations for dual eligibles, with 419,450 total members. There are currently about 2.94 million people enrolled in duals plans nationwide.

Source: AIS’s Directory of Health Plans

Datapoint: Year-Over-Year Medicaid Enrollment

April 24, 2019

Nationwide enrollment in Medicaid and CHIP shrunk 0.46% to 74.4 million lives from April 2018 to April 2019, according to the latest update to AIS’s Directory of Health Plans. This includes enrollment in both Medicaid fee-for-service and managed care plans.

Nationwide enrollment in Medicaid and CHIP shrunk 0.46% to 74.4 million lives from April 2018 to April 2019, according to the latest update to AIS’s Directory of Health Plans. This includes enrollment in both Medicaid fee-for-service and managed care plans.

Source: AIS’s Directory of Health Plans