Aetna recommended for new D-SNP contract by the State of Michigan
Aetna, a CVS Health company, has been recommended by the State of Michigan for a new contract to serve MI Coordinated Health beneficiaries eligible for both Medicare and Medicaid. The contract will provide a Highly Integrated Dual Eligible Special Needs Plan (HIDE SNP), offering Medicare benefits, most Medicaid covered benefits, and integrated long-term services and supports.
Aetna will continue serving 10 counties and expand to 29 additional counties in 2027. The company has been serving dually eligible beneficiaries in Michigan for over 10 years, currently managing health benefits for about 8,500 members. The new contract is expected to begin on January 1, 2026, and end on December 31, 2033, with renewal options.
Aetna, una società di CVS Health, è stata raccomandata dallo Stato del Michigan per un nuovo contratto destinato ai beneficiari del MI Coordinated Health idonei sia per Medicare che per Medicaid. Il contratto offrirà un Piano Speciale per Bisogni Speciali per Doppia Idoneità (HIDE SNP), fornendo prestazioni di Medicare, la maggior parte dei benefici coperti da Medicaid e servizi e supporti a lungo termine integrati.
Aetna continuerà a servire 10 contee e si espanderà a 29 ulteriori contee nel 2027. L'azienda opera per oltre 10 anni con beneficiari dually eligible in Michigan, gestendo attualmente i benefici sanitari per circa 8.500 membri. Si prevede che il nuovo contratto inizierà il 1 gennaio 2026 e terminerà il 31 dicembre 2033, con opzioni di rinnovo.
Aetna, una compañía de CVS Health, ha sido recomendada por el Estado de Michigan para un nuevo contrato destinado a los beneficiarios de MI Coordinated Health que son elegibles tanto para Medicare como para Medicaid. El contrato proporcionará un Plan de Necesidades Especiales Duales Altamente Integrado (HIDE SNP), ofreciendo beneficios de Medicare, la mayoría de los beneficios cubiertos por Medicaid, y servicios y apoyos de largo plazo integrados.
Aetna continuará sirviendo a 10 condados y se expandirá a 29 condados adicionales en 2027. La compañía ha estado sirviendo a beneficiarios elegibles dualmente en Michigan durante más de 10 años, gestionando actualmente los beneficios de salud para aproximadamente 8,500 miembros. Se espera que el nuevo contrato comience el 1 de enero de 2026 y termine el 31 de diciembre de 2033, con opciones de renovación.
Aetna는 CVS Health의 회사로, 미시간 주 정부로부터 Medicare와 Medicaid 두 가지에 모두 적합한 MI Coordinated Health 수혜자를 위한 새로운 계약을 권장받았습니다. 이 계약은 통합된 장기 서비스와 지원을 제공하는 고도로 통합된 이중 자격 특별 필요 계획(HIDE SNP)을 제공하여 Medicare 혜택과 대부분의 Medicaid 혜택을 포함합니다.
Aetna는 10개 카운티에서 계속 서비스할 것입니다 그리고 2027년에 29개 카운티로 확장될 것입니다. 이 회사는 미시간에서 이중 자격 수혜자에게 10년 넘게 서비스를 제공해 오고 있으며, 현재 약 8,500명의 회원에 대한 건강 혜택을 관리하고 있습니다. 새로운 계약은 2026년 1월 1일에 시작되어 2033년 12월 31일에 종료될 예정이며, 갱신 옵션이 있습니다.
Aetna, une entreprise de CVS Health, a été recommandée par l'État du Michigan pour un nouveau contrat visant à servir les bénéficiaires de MI Coordinated Health éligibles à la fois pour Medicare et Medicaid. Le contrat fournira un Plan de Besoins Spéciaux à Double Éligibilité Hautement Intégré (HIDE SNP), offrant des prestations Medicare, la plupart des prestations couvertes par Medicaid, ainsi que des services et des soutiens à long terme intégrés.
Aetna continuera à servir 10 comtés et s'étendra à 29 comtés supplémentaires en 2027. L'entreprise s'occupe des bénéficiaires à double éligibilité dans le Michigan depuis plus de 10 ans et gère actuellement les prestations de santé d'environ 8 500 membres. Le nouveau contrat devrait commencer le 1er janvier 2026 et se terminer le 31 décembre 2033, avec des options de renouvellement.
Aetna, ein Unternehmen von CVS Health, wurde vom Bundesstaat Michigan für einen neuen Vertrag empfohlen, der den MI Coordinated Health-Begünstigten dient, die sowohl für Medicare als auch für Medicaid berechtigt sind. Der Vertrag wird einen Hochgradig Integrierten Doppelte Berechtigten Spezialbedarfsplan (HIDE SNP) bereitstellen, der Medicare-Leistungen, die meisten von Medicaid abgedeckten Leistungen sowie integrierte Langzeitdienste und -unterstützungen bietet.
Aetna wird weiterhin in 10 Landkreisen tätig sein und im Jahr 2027 auf 29 weitere Landkreise expandieren. Das Unternehmen bietet seit über 10 Jahren Dienstleistungen für dual berechtigte Begünstigte in Michigan an und verwaltet derzeit die Gesundheitsleistungen für etwa 8.500 Mitglieder. Der neue Vertrag wird voraussichtlich am 1. Januar 2026 beginnen und am 31. Dezember 2033 enden, mit Optionen zur Verlängerung.
- Recommended for new contract to serve MI Coordinated Health beneficiaries
- Expansion from 10 to 39 counties by 2027
- Currently manages health benefits for approximately 8,500 dually eligible members
- Potential 7-year contract with renewal options
- None.
Insights
The State of Michigan's recommendation for Aetna to serve MI Coordinated Health beneficiaries is a positive development for CVS Health. This contract expansion allows Aetna to increase its footprint from 10 to 39 counties by 2027, potentially growing its member base significantly beyond the current 8,500 dually eligible members.
The 7-year contract duration, with renewal options, provides long-term stability and revenue predictability for this segment of CVS's business. The transition from a Medicare-Medicaid Plan to a Highly Integrated Dual Eligible Special Needs Plan (HIDE SNP) aligns with industry trends towards more integrated care models for complex patient populations.
While the financial impact isn't explicitly stated, the expansion into additional counties and the potential for membership growth could positively affect CVS's revenue stream in the coming years. Investors should monitor the implementation and any subsequent membership growth reports to gauge the full impact on CVS Health's bottom line.
This contract win strengthens CVS Health's position in the lucrative dual-eligible market, which is growing due to an aging population. While specific financial figures aren't provided, the expansion from 10 to 39 counties represents a 290% increase in geographical coverage, suggesting significant growth potential.
The long-term nature of the contract (2026-2033) provides revenue stability and allows for strategic planning. However, investors should note that the contract is still subject to a protest period and readiness review, introducing some uncertainty.
The transition to a HIDE SNP model could potentially improve profit margins through better care coordination and cost management. This aligns with industry trends towards value-based care models, which can be more profitable if managed effectively.
Overall, this development is positive for CVS Health's long-term growth strategy in the government-sponsored healthcare segment, which could become an increasingly important revenue driver for the company.
Aetna to support more
Under the new contract, eligible
"Individuals dually eligible for both Medicare and Medicaid often have complex health care needs, making coordination of benefits essential for positive health outcomes," said Jason Smith, Vice President, Duals Markets at Aetna. "We're pleased with this win and the opportunity to continue our partnership with the
Aetna has been serving dually eligible beneficiaries in
Pending the completion of the state's protest period and readiness review, the new contract is expected to begin on January 1, 2026, and end on December 31, 2033, with the option of renewals.
This contract has no impact on the existing contract with Aetna Better Health of
About Aetna
Aetna, a CVS Health business, serves an estimated 36 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental and behavioral health plans, and medical management capabilities, Medicaid health care management services, workers' compensation administrative services and health information technology products and services. Aetna's customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, visit Aetna.com.
Aetna Medicare is a HMO, PPO plan with a Medicare contract. Our D-SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal. Plan features and availability may vary by service area.
About CVS Health
CVS Health® is the leading health solutions company, delivering care like no one else can. We reach more people and improve the health of communities across America through our local presence, digital channels and over 300,000 dedicated colleagues – including more than 40,000 physicians, pharmacists, nurses, and nurse practitioners. Wherever and whenever people need us, we help them with their health – whether that's managing chronic diseases, staying compliant with their medications, or accessing affordable health and wellness services in the most convenient ways. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. And we do it all with heart, each and every day. Follow @CVSHealth on social media.
Media contact
Robert Joyce
Robert.Joyce@CVSHealth.com
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SOURCE CVS Health
FAQ
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