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January 7, 2021

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Centene Boosts Behavioral Health Offerings With Magellan Buy

January 7, 2021

Following the recent acquisition of PANTHERx Rare, LLC and the first- quarter 2020 addition of WellCare Health Plans, Inc., Centene Corp. kicked off the new year with an agreement to purchase Magellan Health, Inc. for $2.2 billion. Magellan also just completed the previously disclosed sale of its managed care division to Molina Healthcare, Inc. The newer transaction will allow Centene to expand its behavioral health platform, increase its specialty health and pharmacy capabilities and enhance its ability to address members’ whole health.

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2021 Outlook: COVID Will Have Lasting Impact on MAO Investment Targets

January 7, 2021

With a new administration that will be focused on the COVID-19 pandemic and improving health care coverage, industry experts do not anticipate major changes to the Medicare Advantage program, although many agree the pandemic will leave a lasting impact on the industry. And as President-elect Joe Biden looks to expand coverage, MA will likely be held up as a “successful example of a public-private mechanism to take Medicare eligibility to age 60,” predicts Wunderman Thompson Health’s Lindsay Resnick.

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MCOs Mull Managing Care for Duals in FFS Medicare Demo

January 7, 2021

With the aim of improving care for dual eligible individuals while promoting value-based care in fee-for-service Medicare, CMS last month introduced a new option for certain Medicaid managed care organizations to become Direct Contracting Entities (DCEs) that will coordinate care and share risk for duals who access their Medicare benefits through FFS. But some MCOs have questions about the design of the model, and one organization warns that the arrangement could have a detrimental impact on accountable care organization (ACOs) that have made significant investments in value-based care.

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2021 Outlook: COVID Vax, State Budget Issues Add to Medicaid MCOs’ Urgency to Address Disparities

January 7, 2021

As the novel coronavirus erupted across the U.S. and created a widespread economic downturn, it led to increased enrollment in state Medicaid programs and created devastating budget shortfalls for states. Yet Congress’ latest pandemic relief effort — the Consolidated Appropriations Act signed by President Donald Trump on Dec. 27 — does not include direct financial help for states, which are now rolling out newly authorized COVID-19 vaccines with limited resources and guidance from the federal government.

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