Humana inks deal to expand in Medicaid managed care


MM Curator summary

[MM Curator Summary]: The buy comes one month after a similar buy by Molina in the same market, and 1 day after the transaction to divest its majority stake in Kindred’s hospice assets completed.


The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.



Dive Brief:

  • Humana said Friday it will acquire most of the assets of Inclusa, a managed care organization in Wisconsin that provides long-term care and support services to seniors and adults with disabilities. Financial terms of the transaction were not disclosed.
  • The deal will boost the number of Medicaid recipients enrolled in Humana plans. The Louisville, Kentucky-based health insurer said it currently covers about 1 million Medicaid beneficiaries across Florida, Illinois, Kentucky, South Carolina and Wisconsin and was recently awarded contracts in Ohio and Louisiana.
  • The acquisition comes a day after Humana completed the $2.8 billion divestiture of its majority interest in Kindred at Home’s hospice, palliative, community and personal care divisions. Those businesses have been restructured into a standalone company.

Dive Insight:

The purchase of Inclusa broadens Humana’s offerings in the rapidly growing Medicaid managed care market.

Enrollment in Medicaid has surged during the COVID-19 pandemic, supported by state expansions and relief legislation that suspended coverage terminations for the duration of the public health emergency. A Kaiser Family Foundation analysis predicted Medicaid enrollment will grow by 25% from 2019 through the end of fiscal year 2022.

Growth in Medicaid managed care organization enrollment has tracked with the overall rise in Medicaid coverage during the pandemic, KFF has found. More than two-thirds of all Medicaid beneficiaries are insured through managed care organizations, according to the nonprofit, and more states are moving to include seniors and people with disabilities in MCOs.

Inclusa provides long-term care and support services to about 16,600 older people and adults with disabilities through Wisconsin’s Family Care Medicaid program. Services promote independent living for beneficiaries. The MCO is contracted with Family Care in 68 of the state’s 72 counties.

The CMS is encouraging managed care plans to help states prevent people from losing their insurance when the federal continuous coverage requirements eventually end. The agency has issued guidance to states for working through the renewal process, calling it the single largest health coverage transition event since the first marketplace open enrollment following enactment of the Affordable Care Act.

Policy experts fear millions of Americans could lose coverage after the pandemic protections expire, and the hope is that insurers will be able to shift Medicaid enrollees who have access to subsidized coverage through the ACA marketplace to those plans.


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