Dive Brief:
- Florida released additional Medicaid managed care contracts last week, including new awards for CVS, UnitedHealth and Molina Healthcare.
- The three insurers were originally cut out of the state’s Medicaid program in initial awards released in April.
- However, the additional contracts posted last Thursday offered awards in regional awards to CVS-owned Aetna Better Health of Florida, Molina Healthcare of Florida and UnitedHealthcare of Florida. Two other plans previously included in awards this spring also received additional or revised contracts.
Dive Insight:
Florida’s managed care program, wherein the state contracts with insurers to deliver health benefits for Medicaid beneficiaries, represents a significant financial opportunity for insurers.
The state’s Medicaid managed care program is one of the largest in the country, and accounts for two-thirds of its more than $28 billion in annual Medicaid spend, according to health policy research firm KFF.
Florida’s first round of contract awards was a particular boon for Centene, a major Medicaid payer, analysts said in April. Meanwhile, losses for UnitedHealth, CVS and Molina weren’t expected to materially affect their earnings.
Still, Molina said it would challenge its contract loss in the state, along with another loss in Virginia.
Molina CEO Joe Zubretsky highlighted some regions in Florida where the state still hadn’t granted maximum awards during the insurer’s first-quarter earnings call in April.
UnitedHealth also pushed back against the contract reprocurement process. In April, the insurance giant filed a formal protest against the Florida Agency for Health Care Administration, alleging the process was illegal, arbitrary and unfair.
In the filing, the insurer also said its substantial interests “will be adversely affected by AHCA's decision to enter into contracts with the Awardees, and not with United.”
No statewide contracts were given out in the latest round of Medicaid awards.
Instead, Molina Healthcare of Florida received a contract for the state’s southern region, which includes Miami-Dade and Monroe Counties. The insurer said the contract will begin on Jan. 1, 2025, and run through Dec. 31, 2030. Molina expects the contract will serve about 90,000 beneficiaries, the payer said in a statement.
Aetna Better Health of Florida won a deal that included three state regions, representing the center and southern tip of the state.
UnitedHealthcare of Florida’s deal covers a large region in the north central part of the state, a central region and the southern tip.
Hospital-owned Community Care Plan’s awards were revised in five of Florida’s nine regions. Florida Community Care, which also received deals in the first tranche of awards, received new contracts in four regions.
