The AIS Data Team has uploaded new enrollment data, now available via the Search Tool and in the In-App Download Enrollment Data Spreadsheets. The data is the latest available, primarily reflecting second quarter 2018 status.
For this update, the following MCO records were removed from the database:
• Employees Group Insurance Division (#1354), removed because membership overlaps other ASO enrollment, including Aetna, GlobalHealth and CommunityCare;
• FamilyCare Health Plans (#86), ceased health plan operations; members were set to transition to CareOregon, Willamette Valley Community Health and Yamhill Community Care
• Mi Salud (#1122), Puerto Rico’s fee-for service Medicaid record, was removed because we were able to communicate with the Puerto Rico Medicaid division to obtain more clarity and attribute enrollment to the contracted MCOs in the commonwealth’s managed Medicaid program. As a result of this change and population and beneficiary changes in the commonwealth, Medicaid enrollment decreased substantially overall, although the contracted insurers – InnovaCare Health Solutions (1132), First Medical Health Plan (1197) and Molina Healthcare (#1545) all showed substantial gains.
• North Carolina State Health Plan (#1460). Blue Cross and Blue Shield of North Carolina is the state health plan's TPA, so lives in this MCO are already counted under BCBSNC's ASO/self-funded enrollment.
Other notable data shifts include:
• Health New England (#471) showed substantial gains in commercial risk enrollment.
• Medicaid FFS enrollment declined substantially in Colorado, Kansas, New Jersey, Oregon and Wisconsin, due to program and/or reporting shifts.
• CareConnect Insurance Company (#1784) continues to decrease significantly as it winds down operations. All of CareConnect's policy coverage will end as of Oct. 31, 2018.
Note: Centene Corporation’s (#1543) acquisition of Fidelis Care (#204) and WellCare Health Plans’ (#206) acquisition of Meridian Health Plan of Michigan (#251) and Meridian Health Plan of Illinois (#1713) both closed since our last update. However, since all acquisitions closed in the third quarter, the affected insurers’ records remain separate, although we have linked the acquired entities to their new parent companies through the owner and owner ID fields. We will combine records reflecting these mergers once the insurers have consolidated their operations and are reporting their enrollment data as combined.
In addition, the following in-app downloads have been updated with the newly posted data:
• Highlights of AIS Enrollment Data
• Payer Portraits
• Specialty Vendors and Affiliates
• Integrated Delivery Systems Report
• Index of Health Insurance Entities
• MCO ID Master
We have also updated the ACO Directory, an Excel spreadsheet of accountable care organizations and other value-based contract agreements entered into by health plans listed in AIS’s Directory of Health Plans, as well as CMS ACOs.