Reprinted from MEDICARE ADVANTAGE NEWS, biweekly news and
business strategies about Medicare Advantage plans, product design, marketing,
enrollment, market expansions, CMS audits, and countless federal initiatives in
MA and Medicaid managed care.
By Lauren
Flynn Kelly, Managing Editor
As several Medicaid-focused managed care
organizations look to Medicare Advantage as a new area of growth for the
companies, executives during recent conference calls to discuss first-quarter
2017 earnings noted that Medicaid continues to present a robust pipeline of
opportunities.
Anthem, Inc., which is implementing new Medicaid
business in Texas and Virginia that is expected to go live later this year,
said it is anticipating the results of six active RFPs in the next couple of
months and monitoring another 15 to 20 RFPs that it expects to be released over
the next year and a half. Those will include opportunities for additional
business in new and existing Anthem states and existing contract rebids, “which
in many cases will offer the potential for additional opportunities” in the
insurer’s current contracts, remarked Chief Financial Officer John Gallina
during an April 26 earnings conference call.
And while WellCare Health Plans, Inc. doesn’t
plan to bid on all RFP opportunities, CEO Kenneth Burdick during a May 3 call
stated, “Given the resources that we have added to our business development
team, we plan on taking more swings and more add-backs.” But he said the
company will remain “strategic and focused” as it looks to participate in
“significant opportunities” that appear over the next year or two.
One state’s rebid process that’s creating
uncertainty among some Medicaid MCOs is Illinois, which in 2018 plans to take
its managed Medicaid program statewide and limit the number of contracted
insurers from the current 12 to between four and seven (MAN 3/30/17, p.
4). The state in February began soliciting bids from interested insurers;
full proposals are due no later than May 15 and awards will be unveiled by the
end of June.
During an April 26 conference call to discuss
first-quarter earnings, Centene Corp. Chairman and CEO Michael Neidorff said he
believes the company is “well positioned” to win in Illinois but whether
Centene continues to move forward with the process will largely depend on the
rate bands and actuarial studies assessing the potential profitability of the
contract. “We have a strong network. We have statewide a lot of places where
others have pulled out recently. They’re asking us to contract with them,” he said.
Cigna Corp., meanwhile, during a May 5
conference call to discuss recent earnings said it does not plan to participate
in the Illinois Medicaid market next year and does not expect that exit to
impact earnings.
https://aishealth.com/archive/nman051117-03?utm_source=Real%20Magnet&utm_medium=Email&utm_campaign=112319014
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