Health Plan Weekly

Health care organizations across the country have poured billions into housing investments in recent years: In the past month, Kaiser Permanente and UnitedHealth Group both announced investments of over $100 million in affordable housing projects. Several health plans tell AIS Health that while they do expect a modest return on investment or reduction in costs from their efforts, they mostly see these expenditures as an act of altruism in line with their missions as stewards of public health.

According to the organizations themselves, total capital allocations to affordable housing investments by Kaiser Permanente, UnitedHealth Group and CVS Health Corp. amount to approximately $1.65 billion combined. A large portion of those funds are allocated to finance investments in affordable housing through the Low Income Housing Tax Credit (LIHTC), a financial instrument rolled out by the federal government in the late 1980s and early 1990s to encourage investment by the private sector in affordable housing.

The end of the COVID-19 public health emergency (PHE) is likely to significantly downsize Medicaid enrollment around the nation, and managed care organizations (MCOs) must figure out how to keep enrollment steady and maintain continuity of coverage among members.

Since February 2020, fueled by a COVID-induced economic downturn and resulting federal policy changes, the Medicaid ranks have ballooned by 14.6 million members, a roughly 21% increase, nearing 86 million enrollees, according to the Kaiser Family Foundation (KFF).

As a condition of receiving enhanced federal funds during the PHE, states have been required to ensure continuous Medicaid and CHIP coverage for most enrollees by pausing eligibility redeterminations. A quartet of large for-profit plans that hold 40% Medicaid market penetration nationally — Anthem, Inc., Centene Corp., Molina Healthcare, Inc., and UnitedHealth Group — are all expecting “modest enrollment declines” once the PHE ends, according to a recent KFF issue brief.

Anthem, Inc. reported strong first quarter financial results, prompting the insurer to raise its earnings guidance for the year. The company attributed the change largely to a lower-than-expected COVID-19 impact, as the Omicron variant and the long-term effect of delayed care during previous COVID peak periods was less severe than Anthem had originally projected in January.

For the first quarter, Anthem generated $8.25 in adjusted earnings per share (EPS), beating the Wall Street consensus of $7.82. The insurer increased its full-year EPS guidance to greater than $28.40, up from its previous EPS estimate of $28.25.  

Innovative, mostly non-medical supplemental benefits have seen tremendous growth in the few years the Medicare Advantage program has allowed them. But that growth is still from a base of zero, and industry experts suggest that numerous barriers are keeping adoption of these new supplemental benefits at a relatively slow pace.

Starting with plan year 2019, MA organizations began offering a wider range of benefits such as Adult Day Care and In-Home Support Services thanks to CMS’s reinterpretation of the definition of “primarily health-related supplemental benefits.” And with the passage of the CHRONIC Care Act of 2018, MA plans in 2020 began offering Special Supplemental Benefits for the Chronically Ill (SSBCI), a category of “non-primarily health related” items and services that can be made available to certain beneficiaries.