The AIS Data Team has posted new data to the subscriber dashboard Online Search Tool and In-App Download Enrollment Data Spreadsheets. This data primarily reflects first-quarter 2021 status but includes some second-quarter 2021 data for Medicare Advantage, dual-eligibles and Medicaid membership.

Most related in-app downloads and special reports now reflect the most recent data available. Keep an eye out in mid-July for a detailed analysis of changes from the fourth quarter, in addition to a year-over-year report on trends from the past year.

For this update, we added the following new MCOs:
• Hamaspik Medicare Select (#1986), a duals plan operating in New York;
• EmblemHealth (#2018), which consolidated all its MCO records into one parent (see below); and
• Quartz Health Solutions, Inc. (#2019), which also consolidated all its MCO records into one parent (see below).

We discontinued the following MCOs:
• ConnectiCare, Inc. (#110); HIP, an EmblemHealth Company (#187); and GHI, an EmblemHealth Company (#218) were all discontinued after our sources at EmblemHealth (#2018) opted to combine all records into one new MCO.
• Gundersen Health Plan (#437) and Unity Health Insurance (#491) were discontinued after our sources at Quartz Health Solutions, Inc. (#2019) opted to combine all records into one new MCO.
• FirstCare Health Plans (#639) consolidated into Scott & White Health Plan (#235) at the insurer's request.
• Johns Hopkins Employer Health Programs (#1819) was discontinued after its members were discovered to be in other insurers' ASO/self-funded.

We renamed two MCOs in this update:
• American Health Advantage of Mississippi (#2016), renamed from American Health Advantage of Missouri due to a discrepancy within the original source files used to create this record;
• My Choice Wisconsin Health Plan (fka Care Wisconsin Health Plan), #969, renamed to reflect its absorption into My Choice Wisconsin.

We added a new parent – Point32Health (#152) – the new name of the combined companies of Harvard Pilgrim Health Care, Inc. (#171) and Tufts Health Plan (#172). CarePartners of Connecticut (#1946), a partnership between Hartford HealthCare and Tufts Health Plan, is also included in this parent rollup due to its ownership by Tufts. The insurers will remain separate entities until otherwise indicated.

Medicaid continues to increase, gaining over 1 million managed Medicaid lives from last quarter; it should be noted that the 3Q vs. 4Q jump of 3 million represented a much longer time period (December 2020 to April 2021). However, gains were generally more moderate than they’ve been since the begin of the COVID-19 pandemic. State Medicaid is still decreasing slightly in some states, usually corresponding to an increase on the Medicaid HMO side.

The most notable shifts in the Medicaid space resulted from insurer absorptions of Medicaid business. Scott & White Health Plan (#235) picked up FirstCare’s (#639) Medicaid membership after contacts at the company opted to combine the records. And Centene Corporation (#1543) scooped up WellCare Health Plans’ (#206) Medicaid contract in South Carolina, as part of the companies’ consolidation. Most other gains were modest.

The public health insurance exchange market jumped over 1.65M from the last quarter, seeing some huge swings, resulting in part from several insurers’ first-quarter 2021 expansions, including:

• Bright Health (#1894) increased its health exchange membership by more than 340K; most of this occurred in Florida.
• Molina Healthcare (#1545) nearly doubled its health exchange membership, adding roughly 302K lives.
• Centene’s health exchange membership took a 10% hit in the first quarter, losing out in Florida and Texas especially.
• Oscar Insurance (#1785) also grew its public exchange membership by over 55%, buoyed by an impressive showing in Florida.
• Percentage-wise, Friday Health Plans (#1879) saw the greatest growth, increasing by 940% due to expansion into several new states.

Commercial risk group enrollment barely dipped in the first quarter, down roughly 100K across all insurers. A few insurers – including Cigna, Blue Cross and Blue Shield of North Carolina, and Anthem, Inc. – made modest gains. In some cases, gains were more prevalent on the ASO/self-funded side, as Blue Cross and Blue Shield of Texas, Premera Blue Cross, Independence Blue Cross, and Priority Health all reported gains of more than 100K (500K in the case of BCBSTX).

Meanwhile, Dean Health Plan (#433) and Kaiser Foundation Health Plan (California, #134, and Colorado, #52) saw significant decreases in ASO/self-funded due to our discovery that some or all ASO/self-funded could be attributed to Medicaid administrative contracts for payers already included in the dataset.

Need more help? Contact support@aishealth.com with questions about how to use or interpret the information provided to you in AIS’s Directory of Health Plans. A member of AIS Health’s support staff would be happy to provide a free demonstration of the website for clients needing more guidance on how to best use this tool.