MM Curator summary
NV MCO winners announced.
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- The state of Nevada intends to award four insurers separate $11 billion contracts to coordinate care for the state’s Medicaid beneficiaries.
- The four-year contracts with UnitedHealthcare, Molina, Centene and Anthem are set to begin on Jan. 1 and run through the end of 2025, according to a notice of award. The insurers have an optional two-year extension in the contract if they can agree to terms with the state.
- The awards must still gain final approval from the Governor’s Board of Examiners, Theresa Carsten with the state’s Department of Health and Human Services, said via email.
It’s a big contract win for Molina, which currently does not provide services to Nevada, per its latest annual report.
The payer, which posted a profit in the second quarter despite increases in utilization and COVID-19 inpatient costs, had 3.9 million Medicaid members as of June 30, a year-over-year jump of nearly 25%.
Molina joins three incumbents, UnitedHealthcare (Health Plan of Nevada), Centene (SilverSummit Healthplan) and Anthem Blue Cross Blue Shield (Community Health Care Plan of Nevada).
A total of eight insurance companies bid on the work, including Aetna, according to state scoring documents related to the request for proposal.
The insurers will offer coverage to about 630,000 Medicaid beneficiaries in Clark and Washoe Counties, representing the Las Vegas and Reno areas respectively.
Nevada, like other states, has reported record Medicaid enrollment as a result of the pandemic, which spurred an economic downturn.
Officials in Nevada said enrollment peaked at 810,000 in February, a new record for the state following the previous high of 690,596 set in August 2018.
The Medicaid and Children’s Health Insurance Program overall now cover one in four people in the U.S., a record high. That was helped in part by the freeze on disenrollment for the COVID-19 pandemic, which will run until the end of the public health emergency that is expected to last at least through this year, as well as an increase to the federal matching rate.