Member: Health Plan Weekly

CVS/Centene Deal Could Portend Big ‘Grab’ for MA Assets

December 9, 2019

CVS Health Corp.’s new agreement to buy Centene Corp.’s Illinois health plan doesn’t fall under the “megadeal” category. But industry experts see broader implications as health care players large and small continue to jockey for position and focus on strengthening their footholds in Medicaid managed care and, especially, the lucrative Medicare Advantage (MA) program.

Just as PBMs were seen previously as “great acquisitive opportunities, now we think the next round of opportunity is grabbing as many MA plans as possible,” and being “opportunistic” when required divestitures in a given state come along, as in this case, Ashraf Shehata, KPMG’s national sector leader for health care and life sciences, tells AIS Health.

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Idaho Tries ‘Enhanced Short-Term Plans’ to Lure Uninsured

December 9, 2019

Taking advantage of regulations loosened by the Trump administration and a new state law, Idaho Blue Cross is now offering short-term health insurance plans that fall somewhere between robust Affordable Care Act (ACA) policies and traditional, leaner temporary coverage options.

Soon, Blue Cross won’t be the only insurer selling what Idaho calls “enhanced short-term plans,” as the state is in the process of approving new offerings from SelectHealth, says Dean Cameron, director of the Idaho Dept. of Insurance. Blue Cross of Idaho has the largest share of the state’s individual market at 48%, followed by SelectHealth at 29%, according to AIS’s Directory of Health Plans.

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Passport Faces New Hurdle in Losing Ky. Medicaid Contract

December 9, 2019

It’s been a rollercoaster for Passport Health Plan in 2019, with the Kentucky plan first warning it was on the brink of insolvency, only to “find a path forward” after the state approved Evolent Health’s deal to buy a 70% stake in Passport for $70 million (HPW 8/12/19, p. 4). But its track recently plunged downward again when the state awarded Medicaid contracts totaling about $7 billion to five MCOs — and incumbent Passport was not among them.

The Kentucky Cabinet for Health and Family Services said Nov. 26 it has selected Aetna Better Health of Kentucky, Humana Health Plan, Inc., Molina Healthcare of Kentucky, UnitedHealthcare Community Plan of Kentucky and WellCare Health Insurance of Kentucky to cover approximately 1.3 million Medicaid beneficiaries in the state starting July 1, 2020, when the current contracts expire.

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UnitedHealth Touts Strong MA, OptumCare Results

December 9, 2019

UnitedHealth Group spotlighted growth and better cost control in its Medicare Advantage (MA) plans, driven in part by the insurer’s value-based provider network strategy, as company officials reiterated expectations of 13% to 16% growth in 2020 earnings per share at UnitedHealth’s annual investor day on Dec. 3.

Strong results in UnitedHealth’s OptumCare medical group segment, which has grown over the past decade to include 18 million patients and 46,000 employed or aligned physicians serving more than 80 health plans and payers, point the way forward for the company’s plans to “reinvent health care delivery,” said Optum CEO Andrew Witty. Some 10,000 of those physicians were added in the last year, Witty told investors.

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Employees Spend an Average 11% of Income on Premiums, Deductibles

December 9, 2019

by Jinghong Chen Average annual growth in employees’ health insurance premium contributions and deductibles increased faster than U.S. median income between 2008 and 2018, according to a recent report from The Commonwealth Fund. On average, employees spent $1,427 on their share of single-plan premiums in 2018, ranging from $755 in Hawaii to $1,903 in Massachusetts. […]

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