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 fourth-quarter 2023 status but includes first-quarter 2024 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 third quarter of 2023.

For this update, we added the following MCOs:

• Senior CommUnity Care of Kentucky (#2046), dual-eligible plan in Kentucky;
• Verda Health Plan (#2048), a Texas dual-eligible plan;
• Peak Health (#2049), a Medicare Advantage (MA) plan based in West Virginia;
• Fenyx Health (#2050), an MA plan in Nevada; and
• Mount Sinai Eldercare (#2051), a duals plan in Florida.

We discontinued six MCOs:

• AgeWell New York (#1899), which ceased operations in 2024;
• **ApexHealth (#1981), which left the Medicare market in 2024;
• **Central Health Plan of California, Inc. (#1158) and Universal Care (dba Brand New Day) (#1380), former Bright Health subsidiaries acquired by Molina Healthcare (#1545) in early 2024;
• Mary Washington Medicare Advantage (#1989), which ceased operations in 2024; and
• Senior Whole Health (#1076), previously acquired by Molina but fully absorbed into the company in late 2023.

We changed one MCO name: Health Partners Plans rebranded and is now Jefferson Health Plans (fka Health Partners Plans); it is MCO #189.
We have not made any changes to the parent-MCO structure of Centene Corporation (#1543) and WellCare Health Plans (#206) as the entities continue to operate as separate brands.
Notable Enrollment Changes

Managed Medicaid enrollment continued to plummet due to eligibility redeterminations, decreasing by nearly 4.9M from the third quarter. The numbers could continue to decrease as states continue the redetermination process, although there may be increases due to members’ being disenrolled in error.

Medicaid FFS membership also fell, losing more than 956K beneficiaries since the third quarter. Because of delays in states’ reporting capabilities, this segment sees lags in their membership decreases. States losing the most membership in their FFS programs were Colorado (228K), Oklahoma (154K) and Illinois (148K).

Notable insurer-level changes in the managed Medicaid space since the last update include the following:

• Elevance Health (fka Anthem, Inc.) (#1264) saw the largest overall decrease, losing nearly 725K members since the third quarter, including 150K in Texas.
• Centene followed Elevance in lives lost, dropping 713K members, primarily due to disenrollments in New York, Texas and Florida.
• In addition, UnitedHealthcare (#1263) saw reductions in many Medicaid states, losing a total of over 316K.
• However, North Carolina’s Medicaid expansion went live in December 2023, adding roughly 328K new members to the five Medicaid HMOs contracted in the state.

Medicaid’s losses were once again the public health insurance exchange market’s gain, as this sector added more than 571K new members since the third quarter. This market will see more increases in the first-quarter 2024 update, due to a record-breaking open enrollment season for this year.

The following insurers saw the most change from developments in the public exchange space:
• Centene Corporation gained 203K exchange members, thanks to its continued strategy of guiding its recently disenrolled Medicaid beneficiaries to its marketplace plans. Gains centered around its Tennessee, Texas and Georgia markets.
• Cigna Corporation (#1224), also fared well, adding 78K public exchange members, fueled largely by adding lives in Georgia and Indiana.
• Molina (#1545) bounced back after seeing attrition in the public exchange market the past several quarters due to its withdrawal from several state exchanges. The company added 74K marketplace members after seeing moderate gains in many of its service areas.

Commercial group risk enrollment decreased marginally since the third quarter, dropping 118K members, although membership in ASO/self-funded increased by nearly 348K. These segments don’t seem to be greatly affected by disenrolled Medicaid beneficiaries, but that could change in the first-quarter update, which will reflect plans beginning in January.

Notable changes include:

• Humana (#1109) continues to siphon off its group members as it winds down commercial markets, losing 70,600 group risk members and 29K non-Tricare ASO members.
• UnitedHealthcare gained 135K ASO/self-funded members, which offset a loss of roughly 88K commercial risk group lives since the third quarter.
• Aetna (#1359) also lost commercial risk group members, dropping 85K members since last quarter.

Medicare Advantage (MA) and duals plans gained nearly 1.16M members via the 2024 open enrollment season; this is the only sector that entirely contains 2024 membership data for this release. Notable changes include:

• Aetna was the biggest winner, by member count, netting 529K new MA members for 2024, a 17% increase over 2023.
• Going by percentage gains, Molina (#1545), increased its membership by 383%, due to its acquisition of Bright Health’s California Medicare business in early January.
• Humana continues its shift to public-sector markets, adding nearly 127K new Medicare members for 2024.
• Devoted Health (#1947) continues to grow its Medicare membership, gaining more than 50K beneficiaries, an increase of 40.75%.

Need more help? The Directory of Health Plans Onboarding training video 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.