Entrance of Additional Carriers Coincides with Wisconsin’s Medicaid Reform Implementation, According to Findings from Decision Resources Group
March 27, 2014 – Burlington, Mass. –
Decision Resources Group finds that residents of the Milwaukee, Wisconsin market are seeing a surge in BadgerCare (Medicaid) options in anticipation of the state’s Medicaid reform implementation in April 2014. UnitedHealth Group (UHG), which withdrew from the Milwaukee managed Medicaid market in late 2012, announced its re-entry in February 2014. In addition, Brookfield-based Trilogy Health Insurance is offering Medicaid plans through a partnership with the largest independent physicians group in the market, Independent Physicians Network (IPN), which will coordinate care for beneficiaries.
Other key findings from the Milwaukee Market Overview
Shifting enrollments: Carriers who administer Medicaid benefits will see shifts in enrollment as the BadgerCare program is reformed. Any resident earning below the federal poverty level will be enrolled in the program, including all childless adults. Adults living above poverty will be removed from BadgerCare and will be encouraged to enroll in private plans through the state’s health insurance exchange.
Medicaid MCO competition: Former managed Medicaid market leader UHG will likely be the biggest challenger to the region’s top managed Medicaid plans for enrollment. UHG’s expansive network of providers and name recognition will likely be big draws for new BadgerCare beneficiaries.
Comments from Decision Resources Group Analyst Sarah Wilson:
“Though UnitedHealth will likely pose the greatest enrollment threat to current market leaders, some residents may be hesitant to enroll in UHG plans because of its decision to withdraw from the market in 2012. Beneficiaries could view plans that have had a consistent presence in Milwaukee more favorably.”
“New BadgerCare beneficiaries, many of whom have been uninsured, will likely have a higher prevalence of untreated chronic conditions and comorbidities. Trilogy’s care coordination agreement with IPN may provide a template for other insurers to manage beneficiary health and keep costs low.”