HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that Texas is planning to move two thirds of its current state-managed fee-for-service Medicaid members into managed care. According to the latest issue of Texas Health Plan Analysis from HealthLeaders-InterStudy, the resulting population of nearly a million managed Medicaid members is attracting new entrants to the state's market, including for-profit health plans like Aetna, Molina Healthcare, and UniCare.
"This change is providing a chance for Aetna to get back into the Medicaid arena in a big way," said Paula DeWitt, HealthLeaders-InterStudy analyst. "For the past few years it looked as if Aetna was getting out of Medicaid completely, and concentrating on its core commercial business. But it seems to have reversed course, starting with Texas."
Molina Healthcare is a for-profit Medicaid-only health plan that has been carefully picking expansion markets. This increase in the managed-care market in Texas provides it with a good opportunity.
These new entrants will face competition from already established managed Medicaid plans in Texas, including AMERIGROUP and Centene Corp.'s Superior Health Plan. All urban areas in Texas will now offer two or three different plans, increasing the range of choice for Medicaid beneficiaries.
The state will actually increase its own fee-for-service plan in rural areas, which are substantially more difficult for managed-care plans to serve.
Other health plan news in Texas: -- Humana has been approved to offer a regional Medicare Advantage PPO in the state. -- Aetna will further expand its focused Aexcel "high performance" specialist network in Texas. -- Commercial HMO membership in Texas continues its decline. About HealthLeaders-InterStudy
HealthLeaders-InterStudy, a company of Decision Resources, Inc. (http://www.decisionresources.com/), is the authoritative source for managed care data, analysis, and news. For more information, please visit http://www.healthleaders-interstudy.com/.
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