Geographic Expansions Assisted 2022 AEP Winners’ Major Gains

Geographic Expansions Assisted 2022 AEP Winners’ Major Gains

by Lauren Flynn Kelly

Medicare Advantage membership has grown by 8.5% since February 2021 to top 28.6 million lives, according to AIS Health’s analysis of data that included enrollment during the 2022 Annual Election Period (AEP). While nearly two-thirds of all new enrollees selected a plan from market leaders UnitedHealthcare, Humana Inc. or CVS Health Corp.’s Aetna, several regional insurers performed well above average, driven largely by service area expansions, provider pacts and benefit enhancements.  

SCAN invests in premium “give-backs” 

• SCAN Health Plan, for one, expanded its reach to two other states this year — Arizona and Nevada. 
• At the same time, the not-for-profit insurer made a string of benefit enhancements and for the first time featured a Part B premium “give-back” in select plans, to which President and CEO Sachin Jain, M.D., attributes much of SCAN’s growth during the AEP.  
• “At a time of inflation and rising costs, older adults, so many of whom are on fixed incomes, found that an attractive proposition,” Jain tells AIS. “One of the most important social determinants of health that we don’t actually acknowledge is disposable income. So, we felt it incumbent on ourselves to offer that rebate as part of our benefits package this year.” 
• According to DHP, SCAN’s membership was close to 272,000 as of February 2022, an increase of 22.7% from a year earlier. “I feel ecstatic about SCAN’s AEP performance,” says Jain. 

Highmark worked closely with providers 

• Highmark Health was another big gainer, as the Pittsburgh-based company saw a return on its expansion into Delaware. The insurer last year unveiled a collaboration with ChristianaCare and Bayhealth to launch an MA plan in Delaware. 
• Alexis Miller, market president, Highmark Federal Markets, says the company is “very pleased with the positive consumer response” in Delaware and that it has been “working more closely with our provider partners to ensure quality care for those eligible, while better managing costs through improved efficiencies.” 

Startups see big payoffs 

• Startup insurers that enhanced their footprints also performed above the industry average.  
• Clover Health saw its MA enrollment climb 27.8% from a year ago to 83,345 as of February 2022. The company doubled its MA service area by adding 101 counties for a total service area of 209 counties across nine states. 
• Alignment Healthcare also added counties in select states and introduced MA plans in Arizona. The insurer now serves more than 92,000 members across four states, an increase of 15% from a year ago.
• And Devoted Health, which recently secured $1.15 billion in Series D funding from investors and added seven Illinois counties to its MA footprint, gained 37,600 members for a year-over-year increase of 111.3%.

From Radar on Medicare Advantage

Subscribers may read the in-depth article online. Learn more about subscribing to AIS Health's publications.