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 third-quarter 2020 status but includes some fourth-quarter 2020 data for Medicare Advantage, dual-eligibles and limited 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 second quarter. In addition, we recently posted the Special Report on 2021 Star Ratings, a report containing AIS Health coverage of the 2021 Medicare Advantage and Part D star ratings.

Medicaid membership continued to climb due to the COVID-19 pandemic in the early part of the quarter, although it leveled off somewhat in November and December. Notable shifts in the Medicaid space include:

• Michigan, which saw the biggest portion of its nearly 11% increase in September, when it jumped 8% from the previous month.
• Puerto Rico, where Molina Healthcare’s (#1545) November exit dispersed its 93K members to the remaining MCOs. Plan de Salud Menonita (#1950) was the Commonwealth’s bigger winning, scooping up 55K new members since our last update.
• Hawaii managed Medicaid also saw increases, due both to COVID-19 and to enhanced reporting from the state Medicaid division. UnitedHealthcare and Kaiser Foundation Health Plan of Hawaii both saw significant jumps in membership.
• Texas saw its fee-for-service membership continue to decrease as its managed Medicaid plans increased; the State of Texas (#1731) lost 67K members as it continues to transition beneficiaries into managed care. California, Illinois, Minnesota, Virginia and Georgia are seeing similar shifts.

Group commercial risk is still decreasing, but not to the degree that had been expected, only dropping from 70.5M to 69.7M since last quarter. Some insurers did take hits, including FirstCare Health Plans (#679), which lost almost 22K members, and UnitedHealthcare, which saw significant decreases in California, Nevada and Washington.

Other notable enrollment shifts since last quarter centered around losses in the administrative services only/self-funded (non-risk) category, likely due to the impact of the COVID-19 pandemic. Aetna (#1359) lost 508K ASO members, followed by UnitedHealthcare, which lost 385K, while Cigna Corporation and Anthem, Inc. (#1264) lost 237K and 190K, respectively.

We are watching the combination between Centene Corporation (#1543) and WellCare Health Plans (#206). We have not made any changes to the parent-MCO structure for this update, but we will continue to analyze our public source data for any transfers from the WellCare to Centene brands and make changes accordingly.

For this update, we added no new MCOs and discontinued the following:
• Children's Medical Center Health Plan (#1897), a Texas-based CHIP plan whose 8,041 moved to other MCOs in its service area when it left the Texas Medicaid market in September 2020.
• NewCourtland LIFE Program (#1515), a Pennsylvania-based PACE plan with 200 members. This record was consolidated under InnovAge (#683), which previously purchased the plan.

We changed one MCO name for this quarter: Arise Health Plan (#440) is now WPS Health Plan (fka Arise Health Plan), to reflect its rebranding.

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.