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June 6, 2024

Medicaid Redeterminations Challenge Plan Finances More coverage of the challenges facing Medicaid managed care with dropping enrollments and rising risk.  I pointed out this possibility in a recent blog here: https://www.healthcarelabyrinth.com/health-plan-economics-part-3-how-falling-medicaid-enrollment-is-impacting-health-plans-and-providers-alike/ (Article may require a subscription.) #medicaid #redeterminations #healthplans managedcare https://www.modernhealthcare.com/insurance/how-medicaid-redeterminations-process-affecting-insurers CVS, Humana Will Lead Cuts To Medicare Advantage A very good article reporting on the current issues facing Medicare Advantage (MA) plans in 2025.  Many plans, especially Humana and CVS Aetna, are expected to pare added benefits back dramatically and could even contract geographies. Hundreds of thousands are expected to have to change plans.  How this all plays out is anyone’s guess, but United could pick up many lives. One interesting note is that margins are eroding but appear to be better with Dual Eligible Special Needs Plans (D-SNPs). In 2021, D-SNPs had margins of 6.4% vs. 2.2% for MA overall. See these blogs I did on the MA

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