Your DHP editors last week made several updates to data in your subscriber dashboard. Several changes in enrollment resulted from substantial contract shifts and corrections, and new health plan executives and updated pharmacy benefit manager (PBM) and Specialty Pharmacy Provider (SPP) contract information were also included. Note: Updates were only made to the data accessed via the search engine; the In-App Downloads do not reflect the revised information at this time.
Changes to the dashboard include:
• WellCare Health Plans, Inc.’s (MCO 206) enrollment and publication note were updated to reflect the company’s acquisition of Phoenix Health Plan Medicaid lives in Arizona. WellCare’s Medicaid enrollment for several states was also updated to reflect updates from state Medicaid agencies.
• Phoenix Health Plan (MCO 24) has been deleted from the database because it was acquired by WellCare Health Plans; enrollment is now reflected in WellCare’s Arizona Medicaid fields.
• Universal American Corp. (MCO 617) was acquired by WellCare (Owner ID 41). Mid-year enrollment updates occurred at the state and local level; the company no longer has enrollment in Florida.
• UnitedHealthcare (MCO 1263) is updated to reflect its new CEO. We also subtracted 400,000 lives from its self-insured/administrative services only (ASO) category nationally to reflect the loss of state employee members to Blue Cross and Blue Shield of Texas (MCO 508). Because these ASO members were not attributed to a state in the original UnitedHealthcare record, we have not modified the Texas-level data for MCO 1263.
• Blue Cross and Blue Shield of Texas’s (MCO 508) ASO enrollment is updated to reflect its win of state employee members from UnitedHealthcare. Other enrollment fields were updated with mid-year data as available. Its publication note was updated to reflect acquisition of Allegian Health Plans (MCO 740).
• Allegian Health Plans, Inc. (MCO 740) was acquired by BCBSTX (MCO 508), a unit of Health Care Service Corporation. Commercial operations are discontinued for this record. All enrollment was updated to its reflect new status.
• LifeWise Health Plan of Oregon (MCO 907) has been deleted from the database due to Premera’s previously announced exit from the state, effective for most remaining enrollees as of September.
• Asuris Northwest Health (MCO 963) has corrected figures provided by the source.
• L.A. Care Health Plan’s (MCO 564) PBM vendor was updated, and mid-year enrollment updates were included.
• Parkland Community Health Plan (MCO 507) has revised PBM, SPP and behavioral health vendors. Mid-year enrollment updates were included.
Specialty Pharmacy Vendors have been updated for the following plans, based on new research and changes in the specialty pharmacy industry:
• Tuality Health Alliance (MCO 87)
• Harvard Pilgrim Health Care, Inc. (MCO 171)
• UPMC Health Plan, Inc. (MCO 213)
• Dean Health Plan (MCO 433)
Please let us know if you have any questions about these revisions.
If haven’t used DHP in a while, check out our Frequently Asked Questions for more insight into how the enrollment fields add up, how the counted medical lives compare with population, and info on how to apply the full capability of the database to your projects.