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 2024 status but includes third-quarter 2024 data for Medicare Advantage, 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 first quarter of 2024.

For this update, we added nine MCOs:

• myPlace PACE, (#2055), a California PACE plan;
• American Health Plans, (#2056), a consolidation of all previous American Health Advantage-branded plans;
• Champion Health Plans-USA, LLC (#2057), a California-based Medicare plan;
• Loma Linda University Health PACE (#2058), a California-based PACE plan
• Curative Insurance Company, (#2063), a commercial plan with lives in Texas and Florida; and
• Vaya Total Care (#2059), Trillium Health Resources (#2060), Partners Health Management, (#2061) and Alliance Health (#2062), Medicaid HMOs operating in a newly introduced tailored plan offering in North Carolina. These plans integrate physical and behavioral health for beneficiaries in the N.C. Medicaid program.

We discontinued six MCOs. ConcertoPACE of Los Angeles (#2044) is technically still active but lost membership to the point of being dropped off the CMS reports; keep an eye out in case it re-enters the dataset. In addition, we consolidated five American Health Advantage MCOs (#1893, 1952, 2015, 2016, 2017, and 2037) into one American Health Plans (#2056) record.

We changed one MCO name: Physicians Health Plan rebranded and is now University of Michigan Health Plan (fka Physicians Health Plan); it is MCO #542.
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

After the first-quarter update yielded the public health insurance exchange market’s record-breaking open enrollment season, this segment saw minor attrition in the second quarter, losing just under 148K members, likely driven by beneficiaries failing to pay their first month’s premium.

The following insurers saw the most change from developments in the public exchange space:

• Exchange juggernaut Centene Corporation still led all insurers in marketplace membership, but saw its numbers decline by nearly 390K, spurred by losses in Texas, Florida and Georgia.
• UnitedHealthcare (#1263) saw increases in its individual market/public exchange membership, which grew by 10% from the first quarter.
• Cigna Corporation (#1224) continues to see decreases in its public exchange membership, losing nearly 99K members since the first quarter.

While Medicaid enrollment continues to decrease; Medicaid HMO membership fell 1.1M since the first quarter. As state Medicaid divisions wind down their redeterminations, we may expect to see some flattening and, in some cases, rebounding on the Medicaid side over the next six months.

Medicaid FFS membership continued its decline, dropping more than 673M members. Delays in states’ reporting capabilities for FFS contribute to lags in their membership decreases, so this segment of Medicaid is still catching up with the pace of managed care. North Carolina saw the greatest decreases in FFS membership (nearly 215K), but this was due to members transitioning from FFS to managed care.

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

• Centene Corporation saw the greatest overall decrease, losing nearly 490K members since the first quarter, due to attrition in several of its Medicaid states.
• In addition, Elevance Health (#1264) saw reductions in many Medicaid states, losing a total of over 241K.
• Humana (#1109) made inroads in both Oklahoma and Ohio, adding a total of 102K members since the last update.

Commercial group enrollment saw slight decreases since the first quarter; group risk dropped 85K members, while ASO/self-funded plans lost 1.31M members.

Notable changes include:

• Humana continues to wind down commercial markets, losing 47,500 group risk members (a 43% decrease) and roughly 31K non-Tricare ASO members.
• UnitedHealthcare lost in both risk and non-risk, losing just over 25K group risk lives and 1M ASO/self-funded members, largely due to continued losses in foreign enrollment.
• This quarter’s biggest commercial risk gainer was Elevance Health, which added 149K commercial group lives; this was offset by a loss of 227K ASO members, however.

Medicare Advantage (MA) and duals plans gained 260K members; because the plan year begins in January, this segment doesn’t see major quarterly shifts. However, Aetna netted nearly 64K 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.