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 2021 status but includes some fourth-quarter 2021 data for Medicare Advantage (MA), dual-eligibles and Medicaid membership.

Most related in-app downloads and special reports now reflect the most recent data available. Keep an eye out in the coming weeks for a detailed analysis of changes from the second quarter. We have also posted a brand new Special Report on 2022 Star Ratings, a PDF download of AIS Health coverage of 2022 MA star ratings.

Note: We will be posting the monthly Public-Sector Plan Enrollment report later this week. Due to timing issues involving the auditing of quarterly data, the data in the monthly report will be more current in many cases than the membership figures in the quarterly reports. For the most updated and granular public-sector membership figures, always consult the monthly public-sector report.

For this update, we added one new MCO: Neighborhood Healthcare PACE (#2022), a PACE plan operating in California.

We discontinued the following MCOs:
• Community Care of North Carolina (#1476), which was removed from the dataset following North Carolina Medicaid's transition to managed care. All previous enrollees are included in either N.C.'s new Medicaid participants (added in the second-quarter update) or the State of North Carolina record (#1560).
• Eon Health Plan (#1906), an MA plan that was consolidated into Clear Spring Health in 2021.

We did not introduce any new parents or owners, but we did update all MCOs under AllyAlign Health (#130) and Trinity Health (#132) to clarify the partnerships between the respective owners and their affiliated MCOs.

In addition, due to the October closure of its acquisition by Molina Healthcare (owner ID #28), Affinity Health Plan (#210) is now represented as a separate MCO under Molina for this update. We will likely consolidate Affinity into Molina in the next update as Affinity’s Medicaid members are in the process of being transitioned to Molina. This change occurred after we finalized third-quarter reports but will be reflected in the monthly public-sector updates.

We continue to track 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 transition to Centene. In this update, WellCare’s Florida Medicaid business and most of its Arizona membership transitioned to Centene. Since WellCare continues to maintain its own branded plans for Medicare and certain Medicaid states, however, we are continuing to separate the two MCOs under the Centene parent.

Medicaid continued to increase, gaining over 1.25M managed Medicaid lives from last quarter, while state Medicaid lost 75K members.

Notable change in the Medicaid space since the last update includes Centene’s aforementioned contract pick-ups due to its consolidation with WellCare’s Medicaid business. In addition, Molina gained nearly 31K new members in Florida as a result of its absorption of Magellan Complete Care (#1795). Also, Priority Health (#545) gained more than 66K new Medicaid members in Michigan as its Total Health Care (#193) subsidiary transferred its membership to the parent company. Commercial consolidation will continue into 2022.

Finally, UnitedHealthcare (#1263) lost 99K Medicaid members in Kentucky; our source at the state informed us that its higher initial enrollment count was based on presumptive eligibility, coverage for which is temporary.

The public health insurance exchange market continued to gain members, increasing over 323K members from the last quarter as the federal and state special election period ended in mid-August. Participants in Florida and Texas saw the most growth, particularly Oscar Insurance, Centene and Bright Health.

Commercial risk group enrollment increased for the first quarter in a while, gaining more than 150K new members from the second quarter. Most other gains and decreases in commercial group risk were modest. UnitedHealthcare led the way here, adding nearly 115K new group risk members, while Anthem followed with 93K.

Administrative services only/self-funded membership increased by more than 342K, with UnitedHealthcare again gaining the most members in this segment, 205,000, and only Triple-S Management Corporation (#1196) losing more than 5% (down 7.8%). However, upon further research into AllWays Health Partners’ (#302) plan offerings, we were able to add an estimated 100K ASO members in self-funded employer plans.

Medicare Advantage plans gained a little over 146K members since last quarter. The most notable movement in this space was Anthem, Inc.’s (#1264) acquisition of InnovaCare Health Solutions’ (#1132) Medicare business, resulting in more than 142K new members for Anthem.

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.