Well known for its acquisitions, Molina Healthcare expanded its existing Medicaid markets and entered a few new markets in 2020. Molina\u2019s strategy to target small private plans and utilize its operational experience has been successful in boosting its growth.<\/p>\n
California-based Molina Healthcare is one of the nation’s largest managed Medicaid organizations with Washington, California, Michigan, Ohio, Illinois, Texas, and Puerto Rico as its top markets. The insurer also offers individual commercial plans and has small Medicare Advantage business geared towards dual eligible members. The insurer serves approximately 3 million individuals overall.<\/p>\n
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New York: <\/strong><\/p>\n The insurer announced to enter into a definitive agreement with a New York-based, Affinity Health Plan for $380 million on Sept. 29, 2020. The deal will focus on Molina\u2019s support to Affinity towards primary care and community health. Affinity Health Plan is one of the largest provider networks in the Greater New York region. The insurer will nearly add 247,000* Medicaid beneficiaries to Molina\u2019s portfolio post acquisition<\/a>.<\/p>\n Additionally, another New York-based health plan, YourCare was acquired<\/a> by the payor on July 1, 2020. With this purchase, Molina will have a larger footprint and 43,000 additional Medicaid members in seven counties in western New York and the Finger Lakes regions. Thus, both the deals provide Molina an expanded market in New York.<\/p>\n Acquisitions<\/strong><\/p>\n In summer 2020, Molina was awarded one of Kentucky\u2019s five Medicaid MCO contracts. \u00a0The contract is effective Jan. 1, 2021 to December 2024.<\/p>\n The insurer bought Kentucky-based Medicaid MCO \u00a0Passport Health Plan on Sept. 1, 2020. Under the agreement<\/a>, Molina will continue the coverage and care for Passport members, will utilize the Passport name, and retain their employees.<\/p>\n <\/p>\n Competition in the Market:<\/strong><\/p>\n Molina competes with various insurers that provide health benefits through contracts with state Medicaid programs and the federal government, including Centene, Humana and UnitedHealth Group.<\/p>\n In January 2020, Centene completed its acquisition of WellCare which expanded its Medicaid market across the nation with 1 in 15 residents covered by Centene. Following this acquisition, the Medicaid market is currently consolidated, which might result in plans offering higher premiums due to payer monopoly. Thus, having new players like Molina in the market can be beneficial as it gives people more options to choose from to get Medicaid coverage. Additionally, Molina can also expect good profit in its new markets following a merger with plans like Magellan and Affinity health which already has a reasonable market share in its respective states.<\/p>\n Key Takeaway<\/strong><\/p>\n Acquiring underperforming plans is an integral \u2013 and effective – part of Molina\u2019s growth strategy. Buying plans that lack the scale to execute innovative ideas and utilize their operational experience to expand Molina\u2019s footprint as well as enhance the product offerings to underserved or underinsured individuals, makes the insurer an important player to watch.<\/p>\n *As per DRG lives data, January 2020.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":" Well known for its acquisitions, Molina Healthcare expanded its existing Medicaid markets and entered a few new markets in 2020. Molina\u2019s strategy to target small private plans and utilize its…<\/p>\n","protected":false},"author":33,"featured_media":97258,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_links_to":"","_links_to_type":0,"footnotes":""},"categories":[19,21],"tags":[90],"class_list":["post-83800","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-biopharma","category-life-sciences-healthcare","tag-market-access","clarivate-product-biopharma"],"acf":[],"lang":"en","translations":{"en":83800},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"pll_sync_post":[],"_links":{"self":[{"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/posts\/83800","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/users\/33"}],"replies":[{"embeddable":true,"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/comments?post=83800"}],"version-history":[{"count":0,"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/posts\/83800\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/media\/97258"}],"wp:attachment":[{"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/media?parent=83800"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/categories?post=83800"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/tags?post=83800"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}\n\n
\n ACQUIRED HEALTH PLANS<\/strong><\/span><\/td>\n STATE<\/strong><\/span><\/td>\n PREDICTED ENROLLMENT*<\/strong><\/span><\/td>\n<\/tr>\n \n PASSPORT HEALTH<\/strong><\/span><\/td>\n Kentucky (New Market)<\/span><\/td>\n 319,289<\/span><\/td>\n<\/tr>\n \n AFFINITY HEALTH PLAN AND YOUR CARE<\/strong><\/span><\/td>\n New York<\/span><\/td>\n 318,885<\/span><\/td>\n<\/tr>\n \n MAGELLAN COMPLETE CARE<\/strong><\/span><\/td>\n Virginia (New Market)<\/span><\/td>\n 109,366<\/span><\/td>\n<\/tr>\n \n MAGELLAN COMPLETE CARE<\/strong><\/span><\/td>\n Florida (New Market)<\/span><\/td>\n 86,602<\/span><\/td>\n<\/tr>\n \n MAGELLAN COMPLETE CARE<\/strong><\/span><\/td>\n Arizona<\/span><\/td>\n 18,802<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n