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Anthem's government business fueled the bulk of its enrollment growth in 2020 as commercial enrollment was stagnant. Overall, Anthem's government business experienced a growth of nearly 17% year over year from 2019 to 2020, while the commercial and specialty unit increased just 0.2%. As part of this latest deal, Anthem is poised to add more than 572,000 government members, a significant one-time pickup. Anthem is set to gain more than 267,000 MA members in the MMM plan, which is the ninth-largest MA plan in the country, according to Anthem, which ended 2020 with 1.4 million MA members, a nearly 18% increase from 2019. Its Medicaid book of business will add more than 305,000 members through the deal, which needs approval from various regulators including the Commonwealth of Puerto Rico. Anthem's Medicaid business pegged enrollment at nearly 9 million at the end of 2020, about a 22% increase from its 2019 Medicaid enrollment. 2021 EPS guidance will not change as a result of the acquisition, Anthem said. Anthem cut its outlook for 2021 as it experienced a rebound in care in the fourth quarter, which weighed heavily on its quarterly profit. Although some insurers reported large profits during periods of 2020 as members deferred care due to the pandemic, companies have warned the trend will ultimately swing in the opposite direction when patients return for care they put off. Insurers expect some members may even be sicker as diagnoses went undetected. Anthem is acquiring the units from InnovaCare and its equity investor Summit Partners, which has invested in a slew of healthcare companies, including U.S. Renal Care, a dialysis operator and MD VIP, a concierge physician practice. Sources: https://www.modernhealthcare.com/insurance/anthem-picks-up-medicaid-plans-puerto-ric  |
Deft Research recently published the 2021 Medicare Shopping and Switching Study. This national market research report of over 3,400 seniors details the shopping and switching habits of these consumers during the most recent Annual Election Period.
In 2020, more carriers, agencies, and consultants relied on the decision-making power of this study than ever before.
Deft's first Executive Research Brief takes a closer look at key report findings linked to CMS benefit design changes. For the 2021 plan year, CMS increased the top value for maximum out of pocket (MOOP) from $6,700 to $7,550. CMS also instituted a Part D Savings Model which limits some insulin copayments to $35.
Deft's study reveals the impact on consumers when MAPD's act on these changes.
- An increase in MOOP of just $100 leads to disenrollment.
- In a market where plan designs are not very different from each other, the value of the MOOP stands out as a competitive advantage or disadvantage.
- Diabetics who switched plans favored enrollment Part D Savings Models.
Get the Research Brief here.
Source: https://www.deftresearch.com/
