UCare is looking to continue its recent rapid growth by competing for Kansas' Medicaid business.
Like other states, Kansas employs private health insurance companies to manage care for beneficiaries of the state's federal Medicaid and CHIP programs. These programs typically target low-income residents.
Last year, the state requested proposals for a new managed care contract starting in 2025, and winners will be announced in April of this year. Minneapolis-based UCare said it is meeting a January construction bid deadline and learning about the Kansas market through meetings with health care providers, community groups and state officials.
“Kansas is not the only state we're looking at,” CEO Hilary Marden-Resnik said in an interview with the Star Tribune.
“There are clear business benefits if we can scale up. [but] “That's not the main reason we're looking at new regions,” Marden-Reznik said, “but it's actually about expanding our impactful mission to benefit from programs like UCare.” This is to expand the scope of the project to the communities that will benefit from it.”
UCare was founded nearly 40 years ago by family medicine physicians at the University of Minnesota to test whether nonprofit health plans could effectively manage the care of Medicaid recipients.
Over the years, UCare also began selling Medicare Advantage coverage for seniors and health plans purchased by individuals on the MNsure insurance exchange.
The coronavirus pandemic caused Medicaid programs across the U.S. to suspend eligibility screenings, causing a surge in enrollment. As a result, UCare has experienced significant growth and increased market share in the Minnesota Medicare market since 2018.
About a year ago, UCare announced it was bidding on Iowa's Medicaid contract, but the HMO was not awarded. Still, Marden-Reznik said the experience helped strengthen the insurance company's application in Kansas.
As it did in Minnesota, UCare could start with Medicaid and expand into the Kansas market for seniors and individuals as the HMO builds a long-term presence in the state, she said. Ta. As of August 2023, Kansas' total Medicaid/CHIP-eligible population was approximately 520,000 people.
“Some other health plans have expanded into new markets and quickly exited,” Marden-Reznik said. “As we think about potential new markets, we also want to think about the next 40-plus years in these markets.”
Last year, UCare announced it would pay the University of Minnesota $100 million as part of a legal settlement in which the university relinquished a majority stake on UCare's board of directors.
The agreement comes more than a year after the university filed a lawsuit seeking to block changes to UCare's board of directors. Illustrating the importance of the U.S. majority, the lawsuit suggests university officials used their position on the board to question UCare's expansion plans in Iowa.
In an interview, Marden Reznik said she could only provide limited comment on the dispute between the university and UCare.
“The UCare board has consistently agreed on what needs to be done,” Marden-Reznik said. “Mainly, this was not about a disagreement within the board.”
Last fall, UCare announced four new board members, two of whom replaced U's representatives. Two of his other newcomers have taken on new positions on the now 17-member board.
Of the carriers selling on MNsure, UCare was the largest at the end of last year. As of 2022, this health insurance company was his fifth largest nonprofit organization in Minnesota, with sales of approximately $6.12 billion.
UCare has approximately 1,600 employees.