Tag Archives: IN
Indiana Medicare Market Overview
Download NowIndiana_Medicare_030421.pdf
IN Section 1915c Appendix K and Approval, May-20
1. Indiana Section 1915(c) Appendix K
2. Indiana Section 1915(c) Appendix K Update
3. Indiana Section 1915(c) Appendix K Approval, Released May 28, 2020
IN Announces Hoosier Care Connect Managed Care Awards, May-20
In May 2020, Indiana awarded Medicaid managed care contracts covering 90,000 aged, blind, and disabled beneficiaries under the state’s Hoosier Care Connect program to Anthem, Centene/Managed Health Services, and UnitedHealthcare. The contracts are worth a total of $6.4 billion. Anthem and Centene were incumbents. CareSource and MDwise, which were also incumbents, were not awarded contracts. Implementation is expected April 1, 2021, with contracts running four years, with two optional one-year renewals.
IN Hoosier Care Connect Managed Care RFP, Proposals, Awards, and Related Documents, 2019-20
1. Indiana Medicaid Hoosier Care Connect (HCC) Aged, Blind and Disabled (ABD) RFP, Issued October 2019.
2. Anthem Proposal, Posted May 26, 2020
3. CareSource Proposal, Posted May 26, 2020
4. Centene Proposal, Posted May 26, 2020
5. MDWise Proposal, Posted May 26, 2020
6. UnitedHealthcare Proposal, Posted May 26, 2020
7. Award Recommendations and Score Sheet, Posted May 26, 2020
8. Addendum #1, Posted October 28, 2019
9. Addendum #2, Posted November 22, 2019
10. Model Contract
11. HCC RFP Attachments, Updated November 22, 2019
12. HCC Pre-Proposal Conference Presentation, Issued November 6, 2019
13. HCC Preliminary Capitation Rates for April to December 2021, Issued November 6, 2019
14. HCC Proposed Capitation Rates for April to December 2021, Issued November 22, 2019
15. HCC RFP Policies and Procedures, Issued January 10, 2019
16. IN Medicaid Managed Care Quality Strategy Plan, 2019
IN Medicaid Managed Care Enrollment Is Up 8.1%, Apr-20 Data
Indiana’s total Medicaid managed care enrollment increased by 8.1% to 1.2 million in April 2020 compared to year-end 2019, after increasing 0.1% in 2019, decreasing 4.6% in 2018 and increasing 3.8% in 2017.
The program saw a gain of 37.3% in 2015 stemming from the Healthy Indiana Plan program, the state’s Medicaid expansion program, which added more than 300,000 members. Effective April 1, 2017, Indiana-based not-for-profit health plan MDwise, Inc., exited Hoosier Care Connect, the state’s Medicaid managed care program for individuals who are in the aged, blind, and disabled (ABD) category of eligibility. Medicaid managed care contracts for Hoosier Healthwise and the Healthy Indiana Plan were awarded in 2016 and began in January 2017, with CareSource being the new entrant.
IN Awards Medicaid Managed Care ABD Contracts
On May 26, 2020, Indiana awarded contracts for Hoosier Care Connect, the state’s Medicaid managed care program for aged, blind, and disabled (ABD) beneficiaries, to incumbents Anthem and Centene/Managed Health Services (MHS), and to UnitedHealthcare. The contracts are worth a total of $6.4 billion. CareSource and MDwise were not awarded contracts. Implementation is expected April 1, 2021, with contracts running four years, with two optional one-year renewals. Hoosier Care Connect serves approximately 90,000 individuals. Read More
IN SNP Membership at 44,215, Mar-20 Data
Indiana had 44,215 Special Needs Plan members as of March 2020.
IN Medicaid Managed Care Enrollment Is Up 3.7%, Mar-20 Data
Indiana’s total Medicaid managed care enrollment increased by 3.7% to 1.2 million in March 2020 compared to year-end 2019, after increasing 0.1% in 2019, decreasing 4.6% in 2018 and increasing 3.8% in 2017.
The program saw a gain of 37.3% in 2015 stemming from the Healthy Indiana Plan program, the state’s Medicaid expansion program, which added more than 300,000 members. Effective April 1, 2017, Indiana-based not-for-profit health plan MDwise, Inc., exited Hoosier Care Connect, the state’s Medicaid managed care program for individuals who are in the aged, blind, and disabled (ABD) category of eligibility. Medicaid managed care contracts for Hoosier Healthwise and the Healthy Indiana Plan were awarded in 2016 and began in January 2017, with CareSource being the new entrant.
MLRs at IN Medicaid MCOs Average 88.6%, 2019 Data
Medical loss ratio for four Medicaid managed care plans in Indiana averaged 88.6% in 2019, compared to 88.0% in 2018. Per member per month premiums averaged $469 among the four plans.
IN Medicaid Fee for Service vs. Managed Care Penetration, 2014-19
Total Medicaid enrollment in Indiana was nearly 1.5 million in 2019. About 75.6% of Medicaid beneficiaries were enrolled in a managed care plan. Total Medicaid expenditures were $12.4 billion in 2019, with about 45.1% through managed care and the rest through fee-for-service.
