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 second-quarter 2023 status but includes third-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. Note: The Key Financial Indicators Quarterly Report will be posted in the next few days; it is delayed due to filing data that was posted late.

Keep an eye out in the coming weeks for a detailed analysis of changes from the first quarter of 2023.

For this update, we added one new MCO: ConcertoPACE of Los Angeles (#2044), a duals plan in California.

We discontinued one MCO: Friday Health Plans (#1879), which ceased operations due to financial difficulties, leaving 125K members up for grabs in the health exchange market.

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

The most staggering changes occurred in the managed Medicaid segment: Due to eligibility redeterminations, Medicaid HMO enrollment decreased by more than 2.1M from the first quarter. It is expected to continue to fluctuate (primarily decreasing) over the next year as states continue the process. Medicaid FFS membership also fell, but only by 56K – this is due to a lag time data reporting capabilities.

The public health insurance exchange segment saw very small gains, adding 86K new members; it’s expected that this market will eventually see greater increases as those disenrolled from Medicaid search for new insurance options. Additionally, the departure of Friday Health Plans left many members up for grabs.

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

• Centene took some of the largest hits in the Medicaid space, losing more than 100K members in three states: Florida (195K), Iowa and Texas.
• Elevance Health (fka Anthem, Inc.) (#1264) also lost members due to Medicaid redeterminations, including 164K in Iowa and nearly 100K in Florida and Texas.
• UnitedHealthcare (#1263) also saw reductions in many Medicaid states, albeit on a less dramatic scope; decreases ranged from 13K to 46K across 10 of its markets.

Commercial group risk enrollment decreased since the first quarter, dropping more than 136K members, while ASO/self-funded decreased as well (34K). These segments could rebound if disenrolled Medicaid beneficiaries obtain employer-based insurance.

Notable changes include:

• Humana (#1109) continues to siphon off group members after the announcement of its intention to withdraw from all commercial markets, losing 47,100 group risk members and 11,100 ASO members.
• Elevance Health lost roughly 118K ASO/self-funded members since the first quarter, as well as 31K commercial risk group members.
• Kaiser Foundation Health Plan, Inc. (#134) lost nearly 39K commercial risk group members.

Medicare Advantage (MA) plans gained nearly 145K 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.