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 fourth-quarter 2022 status but includes first-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 third quarter of 2022.

Note: Due to timing issues involving the auditing of quarterly data, the data in the monthly Public-Sector Plan Enrollment 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 new MCOs operating in the Medicare Advantage (MA) and dual-eligible markets:

• eternalHealth (#2036), an MA plan based in Massachusetts;
• American Health Advantage of Iowa (#2037), an MA plan based in Iowa;
• Gold Kidney Health Plan (#2038), an MA plan operating in Arizona;
• Milford Wellness Village PACE, LLC (#2039), a duals plan in Delaware; and
• Baptist Health PACE (#2040), a duals plan in Arkansas

We discontinued six MCOs:
• InnovaCare Health Solutions (#1132), which left the Medicare and duals market in 2023;
• Inter Valley Health Plan (#155), which left the Medicare market for 2023;
• MoreCare (#1990), which did not renew its Medicare contract for 2023;
• Vibra Health Plan #1913), which did not renew its Medicare contract for 2023;
• Vivida Health Plan (#1956), which was acquired by Elevance Health's (#1264) Simply Healthcare Plans, Inc., subsidiary in late 2022; and
• Wabash Memorial Hospital (#1184), which left the Medicare market for 2023.

We also renamed several MCOs due to insurers’ rebranding efforts:
• Capital Health LIFE (fka LIFE St. Francis), MCO #1383;
• CCA Health Michigan (fka Reliance Medicare Advantage), MCO #1982;
• Chorus Community Health Plans (fka Children's Community Health Plan), MCO #1151;
• Mass General Brigham Health Plan (fka AllWays Health Partners), MCO #302;
• Orangeburg Senior Helping Center (fka Oaks PACE, The), MCO #1358;
• Trinity Health LIFE New Jersey (fka LIFE at Lourdes, Inc.), MCO #1381; and
• **VNSNY Health, MCO #1237

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

Medicaid continued its gains, adding more than 1.4M members since the third quarter, while state Medicaid gained over 290K members.

Notable gains in the Medicaid space since the last update include the following:

• Aetna’s (#1359) departure from Pennsylvania Medicaid meant their 276K lives were up for grabs among the remaining plans. AmeriHealth Caritas, UPMC Health Plan, Health Partners Plans and Geisinger Health Plan were the largest beneficiaries, each gaining at least 92K new members.
• North Carolina, which is expanding its Medicaid program, continues to see growth in its existing managed Medicaid market. Its Medicaid HMOs gained a little more than 143K members since last quarter.
• Elevance Health (fka Anthem, Inc.) (#1264) picked up 62K members in Florida, thanks to its acquisition of Vivida Health Plan (#1956).

The public health insurance exchange market dipped after increasing in the third quarter, losing roughly 320K members; we expect to see large gains in this market in the first quarter of 2023, buoyed by a record-breaking open enrollment. Most notable shifts in the public exchange space occurred in California, including:

• Kaiser Foundation Health Plan, Inc. (#134) lost nearly 91K members in the fourth quarter; this could be attributed to a lag in membership reporting by Covered California, however.
• Similarly, Blue Shield of California (#136) also saw a decrease, losing a little over 67K exchange members.
• Elevance Health fared better in California, adding more than 22K marketplace members in the fourth quarter in the state.

Commercial risk group enrollment decreased since the third quarter, dropping nearly 325K members, but ASO/self-funded increased by 165K members. Meanwhile, the individual market continued its surge, growing by 120K members; these figures do not yet include the 2023 open enrollment season, which saw unprecedented growth. Notable changes include:

• UnitedHealthcare reported an ASO/self-funded increase of 140K members, while Cigna Corporation and Aetna also saw healthy jumps of 58K and 44K, respectively.
• Oscar Insurance (#1785) gained more than 69K individual risk members, bolstered in particular by an increase in Florida, while UnitedHealthcare saw an increase of nearly 53K.
• Blue Cross and Blue Shield of North Carolina (#126) took a 42K hit to its commercial group risk membership, while WEA Trust’s (#1110) 29K decrease in group risk represents a 27% drop; the insurer left the market in 2023 and will be removed from the database in the first quarter update.

The biggest percentage increase since the last release came from the Medicare Advantage (MA) and dual-eligibles market, which gained more than 1.4M members via the 2023 open enrollment season; this is the only sector that contains entirely 2023 membership data for this release. Notable changes include:

• UnitedHealthcare was the biggest winner, by member count, gobbling up 637,580 new MA and duals members for 2023, a 7.7% increase.
• Going by percentage gains, Humana Inc. (#1109), continuing its focus on the Medicare market in light of its announced departure from group insurance, gained nearly 480K MA and duals members in 2023, an increase of 9%.
• On the smaller insurer side, Devoted Health (#1947) grew its membership by more than 43K, an increase of 53%.

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.