HelpThe 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 second-quarter 2020 status but includes some third-quarter 2020 data for Medicare Advantage, duals and some Medicaid data.
Most related in-app downloads and special reports now reflect the most recent data available. Keep an eye out next month for a detailed analysis of changes from the first quarter.
The COVID-19 pandemic and its effect on the health insurance industry continued to drive managed Medicaid gains. The grand majority of states increased membership, with only twelve states seeing minor reductions. States with the biggest increases since last quarter include:
• Everything really is bigger in Texas, which gained nearly 550K members in its managed Medicaid plans, with Centene Corporation leading the surge with 127K new members.
• Illinois, which gained nearly 300K members in managed Medicaid since last quarter; each contracted insurer increased by more than 10%, with Blue Cross and Blue Shield of Illinois gaining 15.2%, an increase of 72K lives. Note: This increase was somewhat offset by a corresponding decrease for the State of Illinois fee-for-service (FFS) record, which dipped by 78K. Several states are showing similar signs of transitioning FFS members into managed care plans.
• New York also gained a significant number of new managed Medicaid members, increasing by just under 375K for the quarter. Again, this was offset by a decrease of 213,263 in the State of New York FFS record.
• Georgia, where only of its four Medicaid insurers (WellCare Health Plans, at 9.2%) failed to gain more than 10% in membership over the first quarter.
While group commercial risk had been largely expected to fall off significantly from the first quarter due to COVID-19, researchers only saw a reduction of about 1 million members, representing a 1.6% decrease. Cigna Corporation saw the largest decrease, losing nearly 280K commercial members, while UnitedHealthcare (#1263) dropped 150K. It is important to remember that traditionally, this market stays flat during this time period, and it’s possible that COVID-related decreases are not yet being reflected on insurers’ quarterly reports.
Other notable enrollment shifts since last quarter included the following:
• Molina Healthcare (#1545) gained nearly 50,000 Medicaid, SCHIP and individual members in New York due to its acquisition of YourCare Health Plan Inc. (#689). This change represents a 147% increase for Molina’s Medicaid business in the state. The insurer also lost membership in its Puerto Rico Medicaid plan, as part of its gradual withdrawal from that market, which will be complete later this year.
• WellCare Health Plans (#206) gained 56K new members in Illinois, due to parent company Centene Corporation’s (parent ID #20) Meridian unit’s acquisition of NextLevel Health. Note: Because Meridian Health Plans was originally a WellCare acquisition, membership connected to that unit will be represented in WellCare’s record until Centene and WellCare’s records are consolidated (see below for further explanation).
We are still keeping a close eye on the combination between Centene Corporation (#1543) and WellCare Health Plans (#206). We did not make any changes to the parent-MCO structure for this update, but we will be analyzing our public source data for any transfers from the WellCare to Centene brands and make changes accordingly.
For this update, we added two new MCOs:
• PACE Partners of Northeast Florida (#2002), a PACE plan in Florida;
• Ryder Health Plan, Inc. (#2003), a commercial plan in Puerto Rico.
For this update, we discontinued the following MCOs:
• Health Pointe of New York, LLC (#1940), after Healthfirst (#318) acquired its Medicare Advantage membership.
• NextLevel Health (#1919), which ceased operations in July 2020; membership was transitioned to Centene's Meridian unit, included in WellCare's record (#206) at this time.
• YourCare Health Plan Inc. (#689), whose acquisition by Molina Healthcare (#1545) closed in July 2020.
We changed one MCO name for this quarter: Montana Health CO-OP (#1746) is now Mountain Health CO-OP (fka Montana Health CO-OP), to reflect its recent expansion into Idaho and planned 2021 expansion into Wyoming.
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.