Texas markets

13 recent moves by payers to exit or enter the markets

Jacob Emerson-

From multiple payers moving forward with plans to offer coverage in their state’s ACA market to further expansion of Medicare Advantage offerings nationwide, here are 13 recent moves by payers to exit or enter markets:

  1. Etna will offer coverage through Covered California, the state’s ACA market, in El Dorado, Fresno, Kings, Madera, Placer, Sacramento and Yolo counties for 2023.
  2. California Blue Cross Anthem will resume offering coverage through Covered California in San Diego County for 2023.
  3. Blue Cross Blue Shield of Nebraska will offer a new plan to the state market in all 93 counties of the state for 2023. The payer has not offered a plan to the market since 2017.
  4. Max HealthWest Virginia University Medicine’s new health plan, is set to launch statewide on Jan. 1. By 2024, the system plans to begin offering Medicare Advantage plans and eventually a Medicaid managed care plan.
  5. Clover Health plans to offer Medicare Advantage plans in 13 new counties in Georgia, South Carolina and Tennessee in 2023, pending CMS approval. Clover will also leave El Paso County in Texas and Pima County in Arizona.
  6. Health Alignment plans to expand its Medicare Advantage plans to California’s Alameda, Fresno and Madera counties for 2023, pending CMS approval.
  7. Evry Health expands value-based health plans to Austin, Houston and San Antonio, Texas. The Dallas-based insurtech company targets companies with 100 to 2,000 employees.
  8. Canopy health added four Providence hospitals in Santa Rosa, Napa, Petaluma and Healdsburg, Calif., to its network in an effort to compete with Kaiser Permanente in the North San Francisco Bay Area.
  9. centene sells its activities in Spain and Central Europe to Vivalto Santé, a private French hospital group.
  10. UnitedHealthcare is launching a new responsible care organization, NexusACO, in August in Wisconsin for the 2023 plan year.
  11. Cal Optimathe Medicaid provider in Orange County, Calif., plans to launch a health plan in the state insurance market for the 2024 plan year, pending county approval.
  12. MyNEXUS, subsidiary of Elevance Healtha nursing home management company, will expand its post-acute care program in Indiana for Medicare members nationwide over the next six to 12 months.
  13. Molina Health acquires My Choice Wisconsin, a Medicaid managed care organization serving 44,000 members across the state.

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