Category: Exec Summary

Thought Leader Interviews

Aaron Lambert of Healthy Blue Louisiana gives his thoughts on the transformation of LA’s Medicaid program and provides insights on NEMT and administrative simplification. 

Bruce Crosby of Health Velocity Capital weighs in on the impact of politics on the investment outlook, provides details on CareBridge (LTSS space), and the need for deep domain expertise to succeed in Medicaid vertical investing. 

Medicaid Health Plan Financial Performance

The markets responded to the Wellcare-Centene deal. There was mixed EBITDA performance. Most MCOs began to outperform S&P around October. 

Mergers, Acquisitions and Investment Activity

There was extensive plan activity (beyond Wellcare/Centene), especially for provider acquisition and small market buys. On the provider side, home health investment continued and a resurgence of hospice funding was observed. 

Vendor Reviews

Latest reviews focused on technology vendors operating in Medicaid space. 1 vendor achieved 5 out of 5 stars. 3 vendors were rated 3/5 stars, 4 vendors were rated 4/4 stars. 

 

 

Thought Leader Interviews

Robert Garnett of Amerigroup Tennessee talks about the Medicaid Block Grant Proposal and David Tamburri of Health Equity Partners gives his thoughts on the next stage in healthcare investment.

Medicaid Health Plan Financial Performance

Revenues flat for most MCOS, with some increases in EBIDTA for smaller plans. Hiring spikes in August for several plans. Note: Multiple new analyses added to standard MCO reporting this issue

Mergers, Acquisitions and Investment Activity

Trends in ABA provider buys. Navigant Consulting sold. 

Vendor Reviews

6 tech companies, 2 consulting firms, 1 HCBS provider network and 1 device company independently reviewed using our 55-point evaluation. 

Thought Leader Interviews

Erhardt Preiteauer (CEO, CareSource) give his thoughts on effective vendor partnerships; Binoy Bhansali (Sandbox) provides key investment insights for the Medicaid space. 

Medicaid Health Plan Financial Performance

RevThe 2nd quarter of 2019 closed with a cautious outlook from most plans in terms of MLR and growth. PBM spread pricing issues dominated news cycles in key markets (Ohio and Kentucky). Quarter to quarter revenues were flat for most MCOs, but significant increases for Cigna and CVS-Aetna. Stock interest fluctuated during progression of WellCare/Centene deal.

Mergers, Acquisitions and Investment Activity

Centene-Wellcare deal dominated news. Multiple provider-plan deals announced. 

Vendor Reviews

2 companies achieved 5/5 stars. 

Thought Leader Interviews

John Lovelace (President, UPMC) gives his thoughts on what MCOs will be focused on in the next 90 days; Brett Moraski (Frazier Healthcare Partners) provides key investment insights for the Medicaid space. 

Medicaid Health Plan Financial Performance

Most MCOs closed out 2018 with fairly flat revenues and EBITA. Market showed variable interest in Q1 based on pricing and volume behaviors. 

• EOY 2018 analyses in and reviewed. 
• Last analysis before Aetna data and trends absorbed into CVS reporting. 

Mergers, Acquisitions and Investment Activity

• The first quarter of 2019 allowed for a settle down period for the active M&A and regulatory cycles seen in Q3 and Q4 of 2018.
• The big consolidation news of Q1 was the WellCare-Centene deal which would create the largest national Medicaid plan.

Vendor Reviews

Multiple member engagement companies reviewed using our 55-point algorithm.