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 2024 status but includes fourth-quarter 2024 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 2024.

For this update, we added two MCOs, PACE plans based in California: High Desert PACE (#2064) and Family HealthCare Network PACE (#2065).

We discontinued one MCO: My Choice Wisconsin Health Plan (#969), which was consolidated into Molina Healthcare (#1545) following a 2024 acquisition.

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

As states wind down their Medicaid disenrollment, Medicaid enrollment continues to decrease, but at a less drastic rate: Medicaid HMO membership fell by 527K this quarter, after decreasing 1.1M in the second quarter.

And after dropping more than 673M members in the second quarter, Medicaid FFS membership only lost 106K, partially offset by an expansion program in Georgia.

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

• Elevance Health (#1264) saw the greatest overall decrease, losing nearly 199K members since the second quarter, due to attrition in several of its Medicaid states.
• Centene Corporation and its subsidiary WellCare also lost members, losing over 175K total members since the second quarter.
• Humana (#1109) again made inroads in both Oklahoma and Ohio, adding nearly 48K members since the last update.

The public health insurance exchange market rebounded somewhat after seeing minor attrition in the second quarter, when it lost just under 148K members; this segment gained 290K members.

The following insurers saw the highest shifts in the public exchange space:

• Centene Corporation bounced back from a decline in the second quarter, gaining back nearly 85K in the third quarter.
• Oscar Health (#1785) scooped up nearly 58K new members, fueled by gains in Georgia and Florida.
• Molina recovered some of its exchange membership, adding 24K exchange lives since the second quarter.

Commercial group enrollment again saw slight decreases since the second quarter; group risk dropped 121K members, while ASO/self-funded plans gained 96,700 members.

Notable changes include:

• Regence BlueShield of Idaho (#397) took over Blue Cross of Idaho's (#396) contract with the State of Idaho government employees health plan, resulting in a gain of roughly 62K group members in 3Q24 and a corresponding loss for BC of ID.
• Humana continues its departure from Commercial group, dropping another 36K members; only 25,900 commercial risk members remain.
• This quarter’s biggest ASO/self-funded gainer was Aetna (#1359), which added nearly 56K ASO members.

Medicare Advantage (MA) and duals plans gained 220K members; because the plan year begins in January, this segment doesn’t see major quarterly shifts. However, Humana netted nearly 54K new members from the last update, the largest increase overall.

Need more help? The Directory of Health Plans Onboarding training video 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.