State officials opened Medi-Cal managed care to other insurers because current contracts in the two counties have been in place for some time, the California Department of Health Care Services said. Medi-Cal managed care, currently made up of 22 insurers, allows insurers to receive a fixed amount from the state per enrollee.
Hartford, Conn.-based Aetna wants to partake in the program because of Medi-Cal’s expansiveness, a spokesperson told California Healthline. The insurer hopes one of its plans, Aetna Better Health, will eventually cover 150,000 Medi-Cal members and extend beyond San Diego and Sacramento Counties.
As for Minnetonka, Minn.-based UnitedHealthcare, a spokesperson said the insurer’s decision to enter the program stems from its success in other state Medicaid programs, California Healthline reported. The insurer already has 3.7 million employer-based or Medicare members in California. However, UnitedHealthcare recently announced its exit from most state exchanges next year, including Covered California.
The insurers’ start date with Medi-Cal plans will be July 2017, pending state approval.
More articles about payer issues:
Anthem to DOJ: Cigna merger will boost insurance market
CareFirst BCBS revises rate requests in Maryland
Insurers, consumers debate up to 48% rate increases in Pennsylvania
At the Becker's 5th Annual Fall Payer Issues Roundtable, taking place November 2–3 in Chicago, payer executives and healthcare leaders will come together to discuss value-based care, regulatory changes, cost management strategies and innovations shaping the future of payer-provider collaboration. Apply for complimentary registration now.
