Two St. Louis-based health care organizations, Ascension and Centene Corp., a Medicaid managed care company, said on July 30 they're exploring a joint venture to establish a Medicare Advantage plan and make it available in multiple geographic markets beginning in 2020.
Neidorff
Medicare, the federal health insurance program primarily for people age 65 and older, covers 58 million people. Last year, about 19 million of them were in enrolled in a Medicare Advantage plan, according to data on the Henry J. Kaiser Family Foundation website, a nonprofit that provides information on health care issues. The numbers of Medicare beneficiaries in private plans, such as Medicare Advantage plans, has more than tripled from 2004 to 2017.
Companies contract with Medicare to offer Medicare Advantage health plans. Traditional Medicare provides hospital insurance in Medicare Part A and medical insurance in Medicare Part B. Individuals can opt to pay an additional premium for drug coverage. In Medicare Advantage Plans, sometimes called Medicare Part C, the medical and hospital insurance are offered through private companies. Most of these plans include prescription drug coverage and may include dental and vision coverage, according to Medicare.gov, the official site for Medicare information. The plans set the premiums, co-pays, deductibles and coverage rules. They may be structured as health maintenance organizations or preferred provider organizations.
In announcing that they had signed a nonbinding letter of intent, Ascension and Centene did not say to what extent the venture would rely on Ascension's provider networks and facilities.
Tersigni
Michael F. Neidorff, chairman and chief executive of Centene, said that together he and Anthony R. Tersigni, Ascension's president and chief executive, have decades of experience across markets. The proposed joint venture, he said in a release, "presents an opportunity for scaled payer-provider collaboration." He said the organizations plan to leverage their best capabilities to provide high-quality affordable health care.
In the joint press announcement, Tersigni said, "Working with Centene to create a new Medicare Advantage plan aligns with our mission of serving those who are vulnerable and struggling the most, which all too often includes our seniors." He added that developing innovative, transformational approaches to provide health care to seniors is part of Ascension's "advanced strategic direction."
Ascension provides health care in 22 states and in Washington, D.C. Centene said as of June 30, it had managed care membership of 12.8 million people, an increase of about 584,700 members, or 5 percent, from the previous year. Centene said that it is the largest Medicaid managed care company in the U.S. and the largest insurance carrier on health insurance marketplaces. It has more than 7 million members in its Medicaid-related offerings. As of June 30, Centene said it has 343,800 people covered in Medicare-related plans.
Copyright © 2018 by the Catholic Health Association
of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3490.