HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that health plans specializing in managed Medicaid, including Centene Corp., WellCare Health Plans, AMERIGROUP Corp., and Molina Healthcare, have been gaining contracts with various state Medicaid agencies. According to HealthLeaders- InterStudy health plan and healthcare market research, another surprise is Aetna's reentry into the Medicaid market.
"States are realizing that they can show significant savings by moving Medicaid consumers into care management plans," said Jane DuBose, HealthLeaders-InterStudy analyst. "Some years of experience with disease- and care-management tools in various states have given health plans the confidence that they can control costs, allowing them to bid aggressively for this business. Even Aetna, which moved out of Medicaid a few years ago, is gearing up for an expansion, starting in Texas."
Many local and regional health plans have also been expanding their Medicaid business. States with recent activity in Medicaid contracts include Ohio, Georgia, Indiana, and Texas.
Texas is where Aetna has chosen to start its return to managed Medicaid, by winning contracts to serve Medicaid and CHIP members in two counties. Aetna says its potential expansion into Medicaid managed care in additional states is motivated in part by the company's focus on racial and ethnic disparities in healthcare. It is likely to offer managed Medicaid services in areas where it already has a strong commercial presence. It can then take advantage of its existing provider networks.
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