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 2023 status but includes fourth-quarter 2023 data for Medicare Advantage (MA), dual-eligibles and some 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 of 2023.

For this update, we added one new MCO: AgeWell PACE (#2045), a dual-eligible plan in California.

We discontinued two MCOs:

• True Health New Mexico (#1939), which ceased operations after gradually winding down its offerings; and
• Virginia Premier Health Plan (#389), whose 127K member Medicaid plan was fully absorbed into Sentara Health Plans, Inc. (#531) post-merger.

We have not made any changes to the parent-MCO structure of Centene Corporation (#1543) and WellCare Health Plans (#206) as the entities continue to operate as separate brands.
Notable Enrollment Changes

Managed Medicaid continues its relatively steep descent: Once again due to eligibility redeterminations, Medicaid HMO enrollment decreased by more than 2.8M from the second quarter (and nearly 5M overall since the fourth-quarter 2022 update). These numbers are still expected to continue to decrease over the next year as states continue the redetermination process, although some states may rebound due to expansion or other state-specific factors.

Medicaid FFS membership also fell sharply, losing more than 955K beneficiaries since the second quarter. Due to states’ reporting delays, this segment is likely to see lags in their membership decreases. States losing the most membership in their FFS programs were Massachusetts (372K), North Carolina (214K) and Arkansas (148K).

Notable insurer-level changes in the managed Medicaid space since the last update include the following:

• Centene saw the largest decreases in Medicaid membership, losing nearly 489K members since the second quarter, primarily due to disenrollments in Texas and Florida. However, these losses were largely balanced out in the public-exchange space (see below).
• Elevance Health (fka Anthem, Inc.) (#1264) was also hit hard by Medicaid redeterminations, losing 383K overall, and more than 113K in Texas.
• In addition, UnitedHealthcare (#1263) similarly saw reductions in many Medicaid states, losing a total of over 281K.

The public health insurance exchange market evidently scooped up many disenrolled Medicaid beneficiaries, adding more than 851K new members. This market may also see more increases in the fourth quarter as they continue to pick up those disenrolled from Medicaid.

The following insurers saw the most change from developments in the public exchange space:
• Centene Corporation gained nearly 380K exchange members, thanks to its continued strategy of shepherding recently disenrolled Medicaid beneficiaries into its marketplace plans. Gains centered around its Texas, Florida and New York markets.
• Aetna (#1359) also continues to pick up marketplace members, increasing membership by nearly 122K, driven again by gains in Florida and Texas.
• Rounding out the top three is Cigna Corporation (#1224), which added 77K public exchange members, fueled largely by adding 37K lives in Georgia.

Commercial group risk enrollment decreased slightly since the second quarter, dropping nearly 45K members, while ASO/self-funded decreased as well (93K). So far, these segments don’t seem to be affected by disenrolled Medicaid beneficiaries, but that could change as there can be a lag between when employees gain insurance and show up on the enrollment files.

Notable changes include:

• Humana (#1109) continues to bleed group members as it winds down commercial markets, losing 66,200 group risk members and nearly 115K ASO members.
• UnitedHealthcare made gains in both ASO/self-funded (80K) and commercial risk group (33K) membership since the second quarter.
• Kaiser Foundation Health Plan, Inc. (#134) continues to lose commercial risk group members, dropping 30K members since last quarter, when it lost 39K.

Medicare Advantage (MA) plans gained nearly 174K members; because the plan year begins in January, this segment doesn’t see major quarterly shifts.

Need more help? The Directory of Health Plans Onboarding training video, newly posted to the site, provides a general overview and walkthrough of the tool. To get started, be sure to check out the training video located on the right side of the Dashboard, by choosing From the Editors section, then Directory of Health Plans Training.

In addition, you can 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.