Win some, lose some.
That’s how it goes for Independence Blue Cross subsidiary AmeriHealth Caritas, which manages Medicaid benefits for state governments and has limited opportunities to bid on contracts.
But lately, the wins have been outweighing the losses for the company, which has its headquarters near Philadelphia International Airport and employs 5,600.
That should help AmeriHealth Caritas continue the financial gains it posted last year, when it had net income of $93 million on $6.54 billion of revenue, according to the annual report of Blue Cross Blue Shield of Michigan, which owns 38.7 percent of the company. Independence, which had an overall loss of $54.4 million on $13.8 billion of revenue, owns the remainder.
AmeriHealth Caritas came out a winner in the competition for Iowa’s $5 billion Medicaid market, signing up 215,644 Medicaid beneficiaries, putting it slightly ahead of its giant competitors AmeriGroup and UnitedHealthcare, as of Tuesday.
The Pennsylvania Department of Human Services in April approved AmeriHealth’s bid to expand to 14 counties in the southwestern part of the state starting in January under a new three-year contract.
That means AmeriHealth Caritas will cover the entire state geographically, where it already has the largest market share of Medicaid beneficiaries, with 665,452 people signed up for its plans in March, according to Pennsylvania DHS data.
In Nebraska, by contrast, AmeriHealth Caritas lost its bid to continue managing Medicaid benefits through its Arbor Health Plan. After losing an appeal to state officials, the company sued the state last month, alleging that the state didn’t follow its own rules for awarding contracts.
AmeriHealth asked for an injunction that would prevent Nebraska from paying the winners, units of WellCare Health Plans Inc., Centene Corp., and UnitedHealthcare.
Nebraska officials did not provide recent data on AmeriHealth’s market share in the state, but a report last year by Atlantic Information Services Inc. said AmeriHealth was a distant third in the state, behind Aetna and UnitedHealthcare, with 19,736 Nebraskans in its plan.
Date: July 07, 2016