More Signs of Medicare Advantage Retrenchment
A number of plans have already signaled more retrenchment in Medicare Advantage (MA) in 2027. More exits are now being announced. Molina Healthcare will no longer sell Medicare plans in Connecticut, Mississippi, and Nevada. Earlier it said it will get rid of all mainstream, non-Special Needs Plans (SNPs) in 2027. It will also drop SNPs in those three states.
In addition, Health Care Service Corp. (HCSC) plans to exit the Connecticut, New York and District of Columbia MA next year. HCSC will cut its Healthspring-branded MA footprint to 450 counties in 2027 from 580 this year. HCSC reported a $4.57 billion underwriting loss last year. Not too many years ago, HCSC purchased the MA line from Cigna. It may exit 11 additional markets.
Last, CMS will allow MA plans to expand their service areas midyear when acquiring a competitor. The change is out of concern that more health insurance companies will quit the program and disrupt enrollee coverage.
Additional article: https://www.modernhealthcare.com/insurance/mh-molina-medicare-advantage-connecticut-mississippi-nevada/ and https://www.modernhealthcare.com/insurance/mh-cms-medicare-advantage-acquisitions/
#medicareadvantage #enrollment
https://www.modernhealthcare.com/insurance/mh-hcsc-medicare-advantage-exits-connecticut-new-york-dc/
Medicaid MFN Will Have All States
President Donald Trump announced that all 50 states will join in the Medicaid most-favored-nation drug pricing program. Forty states and Puerto Rico have so far signed agreements. The pricing program will reduce net pricing via supplemental rebates to those paid in other countries.
Additional articles: https://www.medpagetoday.com/publichealthpolicy/medicaid/123071 and https://www.beckershospitalreview.com/finance/40-states-join-cms-medicaid-drug-pricing-model-4-notes/
#drugpricing #mfn #irp
https://thehill.com/homenews/administration/6099129-trump-medicaid-drug-prices/
— Marc S. Ryan
