Centene Medicaid Dominance Continues with Delaware Expansion

The insurer now holds Medicaid contracts in 30 states, representing practically 25% of complete market share.

Centene now holds Medicaid enterprise in 30 states with its most up-to-date award in Delaware, introduced final week.

Centene is the nation’s largest Medicaid insurer, with greater than 15 million members, together with 4 of the most important states: California, Florida, New York, and Texas. In Q1 2022, Louisiana and Indiana re-awarded its statewide Medicaid MCO contracts to Centene 

Within the firm’s press launch, Centene CEO Sarah London acknowledged: “We look ahead to constructing on our practically 40 years of Medicaid expertise to enhance well being outcomes for Delaware residents and supply higher worth to the state.”

The Centene award expands Delaware’s Medicaid MCO depend to a few. Highmark Well being Choices Blue Cross Blue Defend has been within the state since 2015 and AmeriHealth Caritas since 2018.

In an company launch, Delaware Division of Well being and Social Companies Secretary Molly Magarik acknowledged: “These firms not solely will provide extra option to our Medicaid members, however additionally they perceive Delaware’s dedication to value-based care, and to the important companies that our Medicaid members want and deserve.”

Delaware Medicaid overview

Diamond State Well being Plan (DSHP) is the identify of Delaware’s Medicaid program, which integrates bodily, behavioral, and long-term care, the latter as part of DSHP-Plus. Whole enrollment is roughly 300,000.

Delaware is considered one of only some states with all-payer benchmarks — Medicaid, Medicare, and industrial insurers — for high quality and spending. Delaware can be a Medicaid enlargement state, with Medicaid/CHIP enrollment rising practically 24% throughout the pandemic (February 2020–March 2022) per information printed by the Kaiser Household Basis.

President and COO Brent Layton added: “It’s a privilege to be chosen by the state of Delaware to supply native healthcare companies and packages that deal with social determinants of well being and take away boundaries to take care of Medicaid members throughout the state.”

Centene’s Medicaid projections

Whereas Q2 2022 efficiency is forthcoming, Layton anticipated the next in Centene’s first-quarter investor name:

• Redeterminations: “Our Medicaid development continues to be aided by the continuing suspension of redeterminations … [W]e anticipate the return of redeterminations in August … and are assured in our skill to retain and entice membership.”
• Change enterprise: “So [in] the 29 states the place we have now Medicaid well being plans, we have now the change or our Ambetter product in 25 of them. So we’re in a position to overlap the counties and in a whole lot of methods, overlap the supplier community.”
• Medicaid pipeline: “There is not any doubt the Medicaid RFP pipeline is reopening. It is far more like a 2017, ’18 and ’19 … [W] we have now ready for these [reprocurements] … However we additionally see a whole lot of new alternatives.”

Layton cites Centene’s shut relationships within the states the place it does enterprise, commenting within the Delaware award launch: “We’re excited to work with the state and suppliers on confirmed fashions of value-based care to ship transformative healthcare and enhance the well being of Diamond State Well being enrollees.”