SCAN plots course for Medicare Advantage growth


SCAN Group plans to expand its Medicare Advantage reach into Texas in 2023 as the insurer stakes its claim in another competitive market for private Medicare plans.

In addition to offering health insurance in Texas, SCAN Group’s not-for-profit insurer, named SCAN Health Plan, will expand its plan options in Nevada during open enrollment this year. Open enrollment runs from Oct. 15 to Dec. 7. Regulators from the Centers for Medicare and Medicaid Services must approve SCAN’s plan to add counties.

The insurer chose to enter Texas at the urging of Prospect Medical in Los Angeles and IntegraNet Health in Houston, said Karen Schulte, senior vice president of network management for SCAN Health Plan. The health systems are part of SCAN Health Plan’s California network and also operate facilities in Texas.

“For SCAN, this is another year of multistate expansion, we’re truly trying to be more of a national player,” Schulte said.

Schulte said the company will expand to another state this year, but she declined to provide specifics.

SCAN ventured outside California last year when it expanded its Medicare Advantage plans to Nevada and Arizona. That strategy worked and the not-for-profit insurer increased its Medicare Advantage membership 17% year-over-year, to more than 270,000 members. SCAN’s growth outpaced the overall Medicare Advantage market increase of 3% last year, according to The Chartis Group, a consultancy. Analysts at the time credited SCAN with capturing market share from Alignment Healthcare, Bright Health Group and other insurers with a heavy California presence.

SCAN is the second-largest not-for-profit Medicare Advantage insurer in the nation, according to Chartis. Kaiser Health Plan is the largest not-for-profit insurer with 12.6 million members, according to the consultancy.

The insurer’s status as a not-for-profit will be a differentiator for the Texas market, Schulte said.

“That is probably something very new and different for both the Houston and San Antonio markets,” she said. “We invest our profits back into the member’s benefits and service, which is something that I don’t know that the Texas markets have heard or seen much of.”

Along with increasing its Medicare Advantage footprint, SCAN Group has invested in a number of healthcare services assets with the aim of diversifying its business.

The parent company in June invested an undisclosed sum in SafeRide Health, a technology company that builds non-emergency transportation service programs for older adults.

In May, SCAN Group paid an undisclosed sum for home care provider The Residentialist Group. The deal represented the first acquisition of an outside company in SCAN’s 45-year history. SCAN merged The Residentialist Group with its provider arm to launch Homebase Medical, a medical group that specializes in home care.

In February, SCAN Health Plan partnered with not-for-profit insurer Commonwealth Care Alliance to launch myPlace Health, a value-based provider that specializes in working with older adults enrolled in the Program for All-Inclusive Care for the Elderly.


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