Health Insurers Outline Medicare Expansion Plans

Margaret Dick Tocknell, May 30, 2012

Major health plans continue to develop and implement growth strategies that focus on health and wellness solutions to address improvements in quality and costs. Insurers are redefining themselves to take full advantage of a market that is shifting from single products to more integrated and comprehensive solutions.

During first quarter of 2012, C-suite executives at the major public health plans outlined during  earnings calls the steps they are taking and the progress they are making on strategies to expand their Medicare and dual-eligible footprint, as well as programs to expand physician engagement and accountable care organizations.

Here are some of the highlights:

Aetna is pricing new and renewal business for a higher level of utilization in 2012. It expects to add about 300,000 new members and end the year with 18.2 million members. The projected growth will be across its Medicaid, Medicare, and commercial business lines.

The insurer continues to look for opportunities to expand its Medicaid footprint. Aetna was one of three plans selected to administer Medicaid services statewide in Missouri beginning July 1. Although Aetna has offered Medicaid plans in parts of the state for 14 years, this will be its first statewide offering.  The contract is projected to add 50,000 members in 2012.

Aetna also has a new Medicaid risk contract in Ohio, which is expected to boost Aetna’s chances to participate in Ohio's dual eligible demonstration pilot program.

Its accountable care solutions business has nine contracts in place and 16 letters of intent.

Margaret Dick Tocknell Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.


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