Dive Temporary:
Florida launched extra Medicaid managed care contracts final week, together with new awards for CVS, UnitedHealth and Molina Healthcare.
The three insurers had been initially reduce out of the state’s Medicaid program in preliminary awards launched in April.
Nonetheless, the extra contracts posted final Thursday provided awards in regional awards to CVS-owned Aetna Higher Well being of Florida, Molina Healthcare of Florida and UnitedHealthcare of Florida. Two different plans beforehand included in awards this spring additionally obtained extra or revised contracts.
Dive Perception:
Florida’s managed care program, whereby the state contracts with insurers to ship well being advantages for Medicaid beneficiaries, represents a major monetary alternative for insurers.
The state’s Medicaid managed care program is likely one of the largest within the nation, and accounts for two-thirds of its greater than $28 billion in annual Medicaid spend, in accordance with well being coverage analysis agency KFF.
Florida’s first spherical of contract awards was a specific boon for Centene, a serious Medicaid payer, analysts stated in April. In the meantime, losses for UnitedHealth, CVS and Molina weren’t anticipated to materially have an effect on their earnings.
Nonetheless, Molina stated it might problem its contract loss within the state, together with one other loss in Virginia.
Molina CEO Joe Zubretsky highlighted some areas in Florida the place the state nonetheless hadn’t granted most awards through the insurer’s first-quarter earnings name in April.
UnitedHealth additionally pushed again in opposition to the contract reprocurement course of. In April, the insurance coverage large filed a proper protest in opposition to the Florida Company for Well being Care Administration, alleging the method was unlawful, arbitrary and unfair.
Within the submitting, the insurer additionally stated its substantial pursuits “can be adversely affected by AHCA’s resolution to enter into contracts with the Awardees, and never with United.”
No statewide contracts got out within the newest spherical of Medicaid awards.
As a substitute, Molina Healthcare of Florida obtained a contract for the state’s southern area, which incorporates Miami-Dade and Monroe Counties. The insurer stated the contract will start on Jan. 1, 2025, and run by means of Dec. 31, 2030. Molina expects the contract will serve about 90,000 beneficiaries, the payer stated in an announcement.
Aetna Higher Well being of Florida received a deal that included three state areas, representing the middle and southern tip of the state.
UnitedHealthcare of Florida’s deal covers a big area within the north central a part of the state, a central area and the southern tip.
Hospital-owned Group Care Plan’s awards had been revised in 5 of Florida’s 9 areas. Florida Group Care, which additionally obtained offers within the first tranche of awards, obtained new contracts in 4 areas.
