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 second-quarter 2021 status but includes some third-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 next month for a detailed analysis of changes from the first quarter.

For this update, we added one new MCO: North East Medical Services (#2021), a PACE plan operating in California.

We discontinued the following MCOs:
• Miami Children’s Health Plan (#1958), a Florida Medicaid plan acquired by Anthem's Simply Healthcare subsidiary in May 2021.
• Trilogy Health Insurance (#1916), a Wisconsin Medicaid plan consolidated into My Choice Wisconsin in summer 2021 after the plans merged.
• US Health and Life Insurance Company (#1584), a commercial plan that ceased offering risk-based insurance in 2021.

We reintroduced the UnitedHealth Group (#39) parent after the insurer acquired PreferredOne (#186) earlier this summer. The MCOs will remain separate until the PreferredOne brand is absorbed into UnitedHealthcare (#1263).

We continue to evaluate the consolidation of Centene Corporation (#1543) and WellCare Health Plans (#206). We have not made any changes to the parent-MCO structure for this update, but WellCare’s Medicaid plans continue to slowly transition to the Centene brand. Since WellCare continues to maintain its own branded plans for Medicare and certain Medicaid states (including its foray into North Carolina Medicaid), however, we are continuing to separate the two MCOs under the Centene parent.

Medicaid continued its increase, gaining over 2.8 million managed Medicaid lives from last quarter, while state Medicaid inched down 77K members.

The most notable change in the Medicaid space since the last update resulted from North Carolina’s new managed Medicaid program, with contracted insurers Blue Cross and Blue Shield of North Carolina (#126), AmeriHealth Caritas Family of Companies (#1007) UnitedHealthcare (#1263), WellCare Health Plans, Inc. (#206) and Centene Corporation (#1543). The new contracted plans enrolled a total of over 1.4M members, reducing membership for Community Care of North Carolina (#1476) by roughly that number. And Centene Corporation (#1543) took over WellCare Health Plans’ (#206) Medicaid contract in Georgia, as part of the companies’ consolidation, adding nearly 436K new members.

The public health insurance exchange market increased over 255K from the last quarter as the federal and state special election period continued; full membership numbers won’t be available until next quarter at the earliest, since the program extended to mid-August. Centene rebounded from its exchange membership loss last quarter, adding nearly 140K new members due to success in Florida, Texas and Georgia. CareSource, Molina and Bright Health also made decent gains from last quarter.

Commercial risk group enrollment was down roughly 388K across all insurers from the first quarter, the bulk of which can be attributed to Blue Shield of California (#136), which lost nearly 280K group members. However, this could be attributed to an error in their state department of insurance filings; we are looking into the decrease. In the same vein, SIMNSA Health Plan (#573) gained nearly 40K members, but it appears that the insurer may have filed its first-quarter 2021 using inaccurate data, and the increase represents a correction. Most other gains and decreases in commercial group risk were modest.

Medicare Advantage plans gained a little over 211K members since last quarter, 61K of which can be attributed to UnitedHealthcare, while Humana (#1109) gained nearly 34K members.

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.