Insurance exchange shoppers in 30 states will be able to find at least one health plan operating as both a private insurer and a Medicaid managed care plan -- a good option for lower-income consumers with fluctuating earnings and a solution to the long-time problem of "churn."
Exchange health plans with this flexibility will be available in some of the largest states, including California, Florida, Illinois, New York and Texas, according to an analysis by Avalere Health.
An option that should help eliminate or reduce the problem of churn, consumers and Medicaid beneficiaries shifting in and out of eligibility and having to switch doctors, the plans "represent an important new pathway to improve continuity of care," Avalere Health executive vice president Matt Eyles said in a media release.
In eight exchanges -- in Colorado, Kentucky, Maryland, Mississippi, New Jersey, Rhode Island, South Carolina and Tennessee -- consumers will find at least one Medicaid managed care organization that's also offering a qualified health plan.
In 19 states, they'll find two or more dual MCO and QHP options, and in California, New York and Texas, they'll find six.
"If more plans decide to bridge Medicaid and exchanges in the future, care continuity and quality could also improve through more consistent sharing of healthcare information about consumers who maintain coverage within the same organization," said Eyles.
The problem of churn dates back to the beginning of Medicaid, plaguing policy makers, providers and managed care organizations ever since.
Expected to be a huge challenge in the Affordable Care Act's roll out, insurers responded with dual offerings, and some states have taken a proactive approach. Earlier this year, Oregon's legislature required qualified health plans to offer similar networks to the Oregon Health Plan, the state Medicaid program, so individuals and families can keep their primary care doctors if they end up switching between the two.
Where exchanges will offer dual QHP and MCO plans, via Avalere Health:
