{"id":86924,"date":"2020-03-04T07:40:39","date_gmt":"2020-03-04T12:40:39","guid":{"rendered":"https:\/\/decisionresourcesgroup.com\/?p=67323"},"modified":"2020-03-04T07:40:39","modified_gmt":"2020-03-04T12:40:39","slug":"cvs-anthem-gained-centene-wellcare-deal","status":"publish","type":"post","link":"https:\/\/clarivate.com\/life-sciences-healthcare\/blog\/cvs-anthem-gained-centene-wellcare-deal\/","title":{"rendered":"What CVS and Anthem Gained From The Centene-WellCare Deal"},"content":{"rendered":"

CVS expanded through IlliniCare Health Plan<\/strong><\/p>\n

The combined carrier formed by Centene and WellCare will have a greater market share with respect to number of enrolled lives. Centene and WellCare had to divest some of their entities to go ahead with the deal. Centene signed a definitive agreement with CVS to divest its Illinois\u00a0health plan subsidiary, IlliniCare Health Plan. The transaction involves Centene\u2019s Medicaid and Medicare Advantage line of business. Centene will retain IlliniCare\u2019s Medicare-Medicaid Alignment Initiative business and IlliniCare’s statewide YouthCare foster care contract, commenced in\u00a0February 2020.\u00a0Centene’s\u00a0Ambetter business in\u00a0Illinois\u00a0will not be affected by the transaction. In 2018, CVS acquired Aetna for $69 billion and expanded its portfolio further into the health insurance market.<\/p>\n

More enrolled lives for CVS\u2019 Medicare Advantage and Medicaid <\/strong><\/p>\n

CVS gained many lives under the Medicare Advantage business which will help it to compete with players like UnitedHealth Group, Humana, and others. Overall, around 8,000 lives were added to CVS\u2019 Medicare Advantage profile and more than 350,000 lives were added to its Medicaid profile. However, Centene will continue to offer Medicaid plans in Illinois through WellCare\u2019s Meridian Health plan, which covers approximately 800,000 enrollees. “Expanding our\u00a0Medicaid\u00a0and\u00a0Medicare Advantage\u00a0presence in\u00a0Illinois\u00a0will allow us to serve more members with our proven holistic approach that addresses physical, behavioral and social determinants of care,” said Karen Lynch, executive vice president of\u00a0CVS and president of Aetna. Financial details of this transaction were not disclosed.<\/p>\n

Anthem expanded in Nebraska and Missouri by 300,000 Medicaid lives <\/strong><\/p>\n

WellCare divested its Nebraska and Missouri Medicaid health plans to Anthem to go ahead with the Centene deal; terms of the deal were not disclosed. Anthem offers Blue Cross Blue Shield plans in 14 states and it will gain approximately 300,000 Medicaid members through this deal. “We look forward to working with our state partners to serve Medicaid members in Missouri and Nebraska with our innovative care management programs designed to improve health outcomes among the most specialized populations,” Anthem President and CEO\u00a0Gail Boudreaux<\/a>\u00a0said.<\/p>\n

Factors that make Medicare and Medicaid fastest growing segments<\/strong><\/p>\n

Medicare and Medicaid are the fastest growing segment of the health insurance market. According to CMS, Medicare and Medicaid spending are expected to grow at 7.6 percent and 6 percent, respectively, per year from 2020 to 2027. Increase in enrollment due to ageing baby boomers and growth in the use of covered services are expected to propel Medicare\u2019s spending growth. Every day 10,000 baby boomers age into the program making it the fastest growing segment. Medicaid\u2019s enrollment mix will be influenced by comparatively more expensive aged and disabled members. CMS also noted that the increased number of plans offered for Medicare Advantage by different players in 2020 might lead to a 14 percent decline in Medicare Advantage premium costs as compared to 2019.<\/p>\n

It would be interesting to see how different players foray or expand into the government-sponsored healthcare market. Mergers, acquisitions, and partnerships by payers are anticipated to continue to offer integrated services in this segment.<\/p>\n","protected":false},"excerpt":{"rendered":"

CVS expanded through IlliniCare Health Plan The combined carrier formed by Centene and WellCare will have a greater market share with respect to number of enrolled lives. Centene and WellCare…<\/p>\n","protected":false},"author":33,"featured_media":0,"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-86924","post","type-post","status-publish","format-standard","hentry","category-biopharma","category-life-sciences-healthcare","tag-market-access","clarivate-product-biopharma"],"acf":[],"lang":"en","translations":{"en":86924},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"pll_sync_post":[],"_links":{"self":[{"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/posts\/86924","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=86924"}],"version-history":[{"count":0,"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/posts\/86924\/revisions"}],"wp:attachment":[{"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/media?parent=86924"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/categories?post=86924"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/tags?post=86924"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}