August 1, 2018

Centene, Ascension explore launching a joint MA plan

Daily Briefing

    Centene on Monday announced that it has signed a letter of intent with the Catholic health system Ascension to launch a joint Medicare Advantage (MA) plan in several U.S. insurance markets in 2020.

    Learn why a successful population health strategy must include Medicare Advantage

    The move comes after Cleveland Clinic last year launched MA plans with Humana and Anthem Blue Cross and Blue Shield of Ohio, Modern Healthcare reports. Those plans do not have monthly premium requirements, but they require members to receive some services exclusively at Cleveland Clinic providers in order for the plan to cover the costs.

    MA plan would be 'preferred model' for Ascension providers

    Centene said the MA plan would be "a preferred model" for the insurer and for providers in the Ascension health system—which is the largest nonprofit health system in the United States—that are located in markets where the plan would be available.

    Centene said the letter of intent "is non-binding," and "the joint venture is subject to due diligence" and "the negotiation of definitive terms and approval by each company's board of directors, among other conditions."

    Centene Chair and CEO Michael Neidorff said, "This joint venture will bring together two leaders with decades of experience across markets and creates an opportunity for scaled payer-provider collaboration." He added that the organizations "share a commitment of serving the underserved and intend to leverage the best capabilities of both organizations to provide high quality, affordable health care to support the needs of low-income seniors."

    Ascension President and CEO Anthony Tersigni said, "Working with Centene to create a [MA] plan aligns with [Ascension's] mission of serving those who are vulnerable and struggling the most, which all too often includes our seniors."

    Implications

    Centene's announcement did not provide any details on how the plan would work or how the companies would enroll members. The companies did not say whether Ascension providers would be the only providers included in the plan's network, nor did they release details on how much the plan would cost for enrollees or how much enrollees would be charged if they receive care at out-of-network providers.

    According to Forbes, the effort "has the potential to be a huge boon of business for Centene," because Ascension "operates more than 2,600 sites of care, including more than 150 hospitals and more than 50 senior living facilities in 22 states and the District of Columbia" (Modern Healthcare, 7/30; Centene release, 7/30; Japsen, Forbes, 7/30; Gooch, Becker's Hospital Review, 7/30; Baker, "Vitals," Axios, 7/31).

    Why a successful population health strategy must include Medicare Advantage

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