Oscar Health is leaving two states by the end of this year and Humana is building hundreds of value-based primary care clinics for Medicare patients across the country. These are 11 recent moves involving payers to exit or enter markets:
Aetna cancels Cerebral contract
Aetna is canceling its in-network contract with mental health startup Cerebral on Aug. 21 for an unknown reason. Cerebral was considered in network with Aetna in 45 states. On June 13, Optum said it would also drop Cerebral from its network in August.
Humana launching Onehome value-based home care model in Virginia, North Carolina
Humana said June 9 it is bringing its value-based home care subsidiary, Onehome, to Virginia and North Carolina to expand in-home services for Medicare Advantage members. The service will launch first in Richmond, Roanoke and Southern Virginia counties. More than 500,000 people with Medicare Advantage plans throughout Virginia and North Carolina will be able to access the service within the next few months.
UnitedHealthcare wins Medicaid contract in Missouri
UnitedHealthcare Community Plan of Missouri was selected by Missouri as one of three managed care organizations to serve Medicaid enrollees in the Temporary Assistance for Needy Families and Children's Health Insurance Program. Beginning July 1, the payer will offer health benefits to a portion of the nearly 1 million adults and children who qualify for the state's Medicaid Managed Care Program.
Humana's Kindred At Home rebrand enters 14 more states
Kindred At Home locations in 14 states transitioned to CenterWell Home Health on June 1 as part of Humana's effort to rebrand its home health division. The final phase is expected to begin in September, with Kindred At Home locations in 17 states making the transition.
Aetna selected for Medicare Advantage contract in Connecticut
Connecticut selected Aetna on June 1 for a three-year Medicare Advantage contract that will serve approximately 57,000 retirees and their dependents across the state, pending negotiations. Spending for the 2023 plan year has a pre-agreement projection of $239.5 million.
Humana partnership to invest $1.2B on 100 more value-based primary care clinics for seniors
Humana and New York City-based investment firm Welsh, Carson, Anderson & Stowe said May 16 they have established a second joint venture to build more value-based primary care clinics for Medicare patients. The partnership will invest $1.2 billion to develop approximately 100 new clinics between 2023 and 2025 and operate them to profitability. Previously, Humana and WCAS invested $800 million to open 67 clinics by early next year.
ChristianaCare expanding Delaware footprint
Newark, Del.-based ChristianaCare said May 16 it will open two new dual practice sites this fall in Milford and Rehoboth, Del., that include a primary care clinic for families and a separate practice exclusively for members of the Highmark Blue Cross Blue Shield Delaware Medicare Advantage plans.
Northwell Health expands patient care to Dominican Republic citizens
Northwell Health said May 12 it will collaborate with Dominican Republic-based payer Seguros Reservas to expand patient care to residents of the Caribbean country. Northwell and Seguros signed a direct services agreement that allows for Seguros members with a JUST plan to travel to any Northwell hospital for treatment.
Oscar Health to exit 2 states
In its first-quarter earnings report released May 10, Oscar Health said it plans to exit the Arkansas and Colorado insurance markets after this year.
Centene subsidiary selected for Missouri foster care specialty contract
Centene said May 6 that its subsidiary, Home State Health, will be the sole provider of a specialty plan under Missouri's Medicaid program, which serves about 40,000 foster children and children receiving adoption subsidy assistance.
Sentara Health Plans to open community care centers
Sentara Health Plans said May 6 it will begin operating community care centers in Virginia and Northeastern North Carolina with a focus on improving care for the uninsured and Medicaid recipients in under-resourced communities. The company is also looking at several more locations by the end of 2022 and has plans for more growth in 2023.