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Briefing: Ohio CO-OP gets CMS loan; Humana, Walmart Rx partnership grows

By Healthcare Finance Staff

A nonprofit in Ohio has been awarded a $129 million loan from the Centers for Medicare & Medicaid Services (CMS) to run a Consumer Oriented and Operated Plan (CO-OP).

The CO-OP will be run by Coorindated Health Plans of Ohio, Inc, a nonprofit operated by the St. Petersburg, Fla.-based Community Health Solutions of America.

CO-OPs are aimed at increasing competition and offering low cost plans through state-based health insurance exchanges. Applications for the fifth round of loan awards were due Oct. 1, and others are expected to be annouced in the coming weeks.  

About $3.8 billion is earmarked for CO-OPs under the Affordable Care Act, and so far, 23 nonprofits in 23 states have received about $1.8 billion in loans.

A perscription drug sales partnership between insurer Humana and retailer Walmart grew by 50 percent last year and now has 1.5 million Medicare members, the two companies announced. 

Started two years ago, the sales partnership offers Medicare Part D plans with premiums of $18.50 a month. With low co-pays, it's billed as an affordable option for thrifty and budget-conscious seniors and is offered in 50 states, with about 1,500 generic perscriptions available.

"By working with Walmart – a leader in cost savings – we're enabling seniors and people with disabilities to better afford their medications," William Fleming, president of Humana Pharmacy Solutions, said in a media release.

Walmart entered the prescription drug market in 2006, and its impact is still being measured. The retail giant has built other pharmaceutical sales models and partnerships, including one with insurer Coventry Health Care, which Aetna is set to acquire for $5.7 billion.

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