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 first-quarter 2024 status but includes second-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 fourth quarter of 2023, and a year-over-year trends report in late July.

For this update, we added two MCOs, both dual-eligible PACE plans:

• St. Vincent PACE (#2053), based in Indiana; and
• Bluegrass PACE Care (#2054), based in Kentucky.

We discontinued two MCOs:

• HMO Partners, Inc. (#133), which, according to the company’s survey, most core business was absorbed into Arkansas Blue Cross Blue Shield (#9).
• Vantage Health Plan, Inc. (#351), which was consolidated into Blue Cross and Blue Shield of Louisiana (#345).

We changed one MCO name: VNSNY Health rebranded and is now VNS Health; it is MCO #1237.
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

The first-quarter update gave the first look at the 2024 public health insurance exchange’s record-breaking open enrollment season – this segment grew by nearly 3.4M members, largely driven by increased subsidy amounts and Medicaid disenrollments due to eligibility redeterminations.

The following insurers saw the most change from developments in the public exchange space:
• Following previous quarters, exchange behemoth Centene Corporation benefitted the most on the exchange from, adding 827K new exchange members. Gains centered around its Florida, Georgia and Tennessee markets.
• Aetna (#1359) also fared well, gaining about 572K new members after expanding to numerous new markets. Florida, North Carolina and Georgia saw particularly strong gains.
• While Cigna Corporation (#1224) had gained members in recent quarters, it lost nearly 330K members in the first quarter, most of it due to decreases in Georgia and Texas.

While Medicaid enrollment has plummeted in recent quarters (nearly 4.9M from the third to fourth quarters of 2024), Medicaid HMO membership lost 238K since the fourth quarter. While this decrease is off the pace of previous updates, it is offset in part by Oklahoma’s entry into managed care; nearly 540K beneficiaries enrolled in the state’s new Medicaid HMO plans ** (Centene Corporation, Aetna and Humana, Inc.).**

Medicaid FFS membership continued its decline, dropping more than 1.1M members, after looking 956K beneficiaries in the fourth quarter. Delays in states’ reporting capabilities for FFS contribute to lags in their membership decreases, so this segment of Medicaid is starting to catch up with the pace of managed care. States losing the most membership in their FFS programs were Oklahoma (552K), California (461K) and Colorado (85K). Note that Oklahoma transitioned to managed care in April, so much of the loss can be attributed to its new HMO program; and California saw many FFS members transition to managed care.

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

• Elevance Health (fka Anthem, Inc.) (#1264) saw the greatest overall decrease, losing 473K members since the fourth quarter, including 224K in California after leaving a few service areas.
• L.A Care Health Plan also lost members in California due to service area changes, dropping 178K members.
• In addition, UnitedHealthcare (#1263) saw reductions in many Medicaid states, losing a total of over 153K.
• The MCOs that benefitted from California’s service area changes were Kaiser Foundation Health Plan, Inc., which gained nearly 750K members; and Partnership HealthPlan of California, which increased by 151K from the fourth quarter.

Commercial group enrollment saw significant decreases since the fourth quarter; group risk dropped nearly 953K members, while ASO/self-funded plans lost 1.36M members.

Notable changes include:

• Humana (#1109) continues to wind down commercial markets, losing 229K group risk members (a 67.6% decrease) and roughly 180K non-Tricare ASO members.
• UnitedHealthcare lost in both risk and non-risk, losing just under 165K group risk lives and 1.575M ASO/self-funded members, largely due to losses in foreign enrollment.
• This quarter’s biggest gainer was Blue Shield of California (#136), which made significant gains in both group risk and ASO membership – 279K and 204K added members, respectively. These increases don’t include the insurer’s recent contract win as sole health plan on the California Public Employees' Retirement System (CalPERS) contract, which is effective in 2025.

Medicare Advantage (MA) and duals plans gained 192K members; because the plan year begins in January, this segment doesn’t see major quarterly shifts. However, Aetna netted 80K 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.