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 2023 status but includes second-quarter 2023 data for Medicare Advantage (MA), dual-eligibles and some Medicaid membership.

Most related in-app downloads and special reports now reflect the most recent data available. Keep an eye out in the coming weeks for a detailed analysis of changes from the fourth quarter of 2022, and a year-over-year trends report in late July.

Note: As of this release, Medicaid redeterminations have had a minimal impact on the data, but we expect to see increased effects in the coming months. Please keep an eye on the monthly Public-Sector Plan Enrollment report, which will show these changes as they occur in our source data. For the most updated and granular public-sector membership figures, always consult the monthly public-sector report.

For this update, we added three new MCOs:

• Horizon PACE (#2041), a duals plan in Kentucky;
• St. Luke's Health Plan (#2042), a commercial plan operating in the individual/public exchange and small group markets in Idaho; and
• Taro Health (#2043), a commercial plan operating in the individual/public exchange and small group markets in Maine.

We discontinued three MCOs:

• Bright Health (#1894), which left the individual and family insurance market in 2023, leading more than 1M members available;
• DAKOTACARE (#353), which was absorbed into parent company Avera Health (#352); and
• WEA Trust (#1110), which left the insurance market for 2023.

We renamed one MCO: Oscar Insurance Corporation is now Oscar Health (#1785), per the insurer’s annual survey response.
We have not made any changes to the parent-MCO structure of Centene Corporation (#1543) and WellCare Health Plans (#206) for this update as the entities continue to operate as separate brands.
Notable Enrollment Changes

The public health insurance exchange market showed the largest gains, adding 2.5M new members after the largest open enrollment in the history of the Affordable Care Act. Additionally, the departure of Bright Health and market reductions of Friday Health Plans (#1879) left many members up for grabs.

The following insurers most benefitted from the developments:

• Health exchange juggernaut Centene Corporation gained more than 1M new members, thanks in large part to gains in Texas, New York and Florida.
• Aetna’s (#1359) massive marketplace expansions in 2023 paid off, resulting in an additional 875K exchange members and benefitting from the aforementioned market exits in Florida, North Carolina and Texas.
• Cigna Corporation (#1224) also fared well, adding nearly 450K new exchange members.
• Smaller regional insurers also made surprising gains, including Baylor Scott & White Health Plan (#235), Piedmont Community Health Plan (#532), and Sentara Health Plans, Inc. (#531), which netted 98K, 11K, and 22K, respectively. These increases ranged from 130%-213% of their previous totals.
• Meanwhile, Friday Health Plans lost nearly 223K members; as several states have put the insurer into receivership, it will continue to lose members in 2023.

Managed Medicaid continued to climb, adding more than 1.1M members since the fourth quarter; as stated above, the reports from which we source managed Medicaid enrollment data have generally not yet begun to show the effects of redeterminations. However, state Medicaid lost over 485K members.

Notable changes in the Medicaid space since the last update include the following:

• Changes in the Massachusetts Medicaid program led to large shifts among with MCOs, with Point32Health, Inc. (#2031) losing nearly 160K members, WellSense Health Plan (fka Boston Medical Center HealthNet Plan, #196) gaining nearly 260K, and the State of Massachusetts (#1683) losing more than 420K.
• Elevance Health (fka Anthem, Inc.) (#1264) picked up nearly 239K members in Ohio, thanks to its acquisition of Paramount Insurance Company’s (#255)** Medicaid contract. Elevance also gained 65K Medicaid members in the District of Columbia after it acquired CareFirst BlueCross BlueShield’s (#368) Medicaid business.
• Arizona was one of the few states where overall decreases of more than 126K can likely be attributed to Medicaid redeterminations at least in part, as the state has already begun the process. Five insurers saw decreases of 15K or more, with UnitedHealthcare (#1263) losing nearly 31K.

Commercial group risk enrollment decreased since the fourth quarter, dropping nearly 802K members, but ASO/self-funded increased by nearly 974K members, suggesting that insurers are shifting their commercial business to ASO/self-funded employers. The commercial risk market could bounce back later this year as a result of Medicaid redeterminations, if many Medicaid beneficiaries have found stable employment.

Notable changes include:

• UnitedHealthcare and Elevance Health each lost roughly 180K commercial group risk members, balanced out by gains in ASO/self-funded membership – 620K for UnitedHealthcare and 104K for Elevance.
• Similarly, Aetna lost about 87K commercial group risk members, but gained 143K ASO members.
• Humana (#1109), which recently reported that it would withdraw from all commercial markets, reduced its commercial membership, losing 33,700 group risk members and 44,500 ASO members.

Medicare Advantage (MA) plans gained just over 69K members; because the plan year begins in January, this segment doesn’t see major quarterly shifts.

Need more help? The Directory of Health Plans Onboarding training video, newly posted to the site, provides a general overview and walkthrough of the tool. To get started, be sure to check out the training video located on the right side of the Dashboard, by choosing From The Editors section, then Directory of Health Plans Training.

In addition, you can 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.