HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that Molina Healthcare Inc. is making a significant expansion of its presence in both the Medicaid and Medicare markets in Michigan. According to the latest issue of Michigan Health Plan Analysis, Molina is launching a Medicare special needs plan (SNP) and acquiring CAPE Health Plan with its 87,000 Medicaid members.
"Medicare/Medicaid dual eligibles are poor, elderly, and tend to have many expensive and difficult-to-treat health problems," said Rick Byrne, HealthLeaders-InterStudy analyst. "The SNP model is based on the idea that chronic case management can handle the health problems of this population in an efficient and cost-effective way. Molina is betting that, with the fully risk-adjusted rates that will be paid to special needs plans in 2007, this will be a profitable line of business for them."
Molina also won SNP contracts in California, Washington, and Utah. Molina is a publicly held for-profit Medicaid health plan, and SNPs are a new line of business for the company.
Molina's acquisition of CAPE will boost its Medicaid membership in Michigan to 231,000, making it the fourth-largest HMO of any kind in the state, and the largest Medicaid plan.
Other health plan news in Michigan: * Initiatives to better manage pharmacy programs are paying off as pharmacy cost trends slow down for Michigan health plans. * Blue Cross Blue Shield of Michigan is integrating depression screening into its array of disease management programs. About Health Plan Analysis
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