Florida ranks No. 48 in a new ranking of state health care systems (and the District of Columbia) published by The Commonwealth Fund, a private foundation that works to achieve better better health care access for low-income Americans, the uninsured, minorities, young children and elderly adults.
Overall, the state’s health care system worsened since last year’s ranking. Deaths from suicide, alcohol and drug use increased during the period studied, according to the report, which contributed to the drop in ranking. The portion of people 64 and younger without insurance, meanwhile, improved.
Source: Sarasota Magazine
WellCare Health Plans, Inc. (NYSE: WCG) announced that it has entered into a definitive agreement to acquire Meridian Health Plan of Michigan, Inc., Meridian Health Plan of Illinois, Inc., and MeridianRx, a pharmacy benefit manager (PBM), (collectively, “Meridian”) for $2.5 billion in cash. The transaction is expected to close by the end of 2018, subject to customary closing conditions, including regulatory approvals.
Meridian expects to generate more than $4.3 billion in total revenue in 2018. As a result of this transaction, WellCare will diversify its Medicaid portfolio through the addition of Michigan, where Meridian has the No. 1 Medicaid market position; deepen its Medicaid business in Illinois; and acquire an integrated PBM platform.
Meridian is one of the largest privately held, for-profit managed care organizations in the U.S. and serves approximately 1.1 million Medicaid, Medicare Advantage (MA), integrated dual-eligible and Health Insurance Marketplace members as of May 1, 2018 in Michigan, Illinois, Indiana and Ohio. With a high-performing culture, Meridian has dedicated more than 20 years to providing compassionate and quality care to its members as demonstrated by achieving high quality ratings from the widely respected National Committee for Quality Assurance (NCQA) for its Medicaid health plans in Michigan and Illinois.
“Meridian is a well-performing health plan, and WellCare and Meridian share a similar commitment to serving our members through a comprehensive, integrated approach to healthcare,” said Ken Burdick, WellCare’s CEO. “This transaction strategically aligns with our focus on government-sponsored health plans, will strengthen our capabilities and growing business, and will meaningfully advance our growth agenda.”
“WellCare’s unwavering commitment to improving the lives of its members makes it an ideal partner,” said David B. Cotton, CEO of Meridian. “Our similar missions, values and goals, combined with WellCare’s dedication to providing an unparalleled member experience, including access to high quality healthcare, were key factors in our decision.”
Meridian has approximately 508,000 Medicaid members in Michigan and 565,000 Medicaid members in Illinois as of May 1, 2018.1 Upon closing, WellCare will have the No. 1 Medicaid membership market share in Michigan and Illinois, increasing its leading market position from four to six states. WellCare will also expand its MA business through the addition of Meridian’s 27,000 MA members in Michigan, Illinois, Indiana and Ohio.1 In addition, as a result of this transaction, the company will add an integrated PBM platform that provides a wide range of services and product offerings to both Meridian’s members and third parties.
Financial Benefits and Transaction Details
The transaction is expected to produce $0.40 to $0.50 of accretion to WellCare’s adjusted earnings per share in 2019, $0.70 to $0.80 of accretion in 2020, and $1.00+ of accretion in 2021, inclusive of $30 million to $40 million in synergies that will ramp up over the next few years and exclusive of one-time transaction-related expenses of $75 million to $85 million and cumulative integration-related expenses of $50 million to $60 million.
WellCare expects to fund the transaction through a combination of cash on hand, the company’s undrawn $1.0 billion revolving credit facility, and, subject to market conditions, new debt of $600 million to $1.0 billion and new equity of $800 million to $1.2 billion. The transaction is not contingent upon financing, and WellCare has secured $2.5 billion in committed bridge financing.
Source: Florida Trend
The past five years have seen a shift in healthcare toward leaner facilities design. For example, more micro-hospitals –small-scale inpatient facilities with eight to 15 short-stay beds-are popping up these days in an industry dominated by megahospitals. Nineteen states and counting now have at least one micro-hospital.
In addition to hospital downsizing, a shift in senior living toward smaller communities is taking place, and, due to consumer demand and rampant retirement insecurity, there’s an anticipated shift toward micro-sizing individual units within assisted living facilities.
Smaller Footprint, Lasting Impression
Micro-hospitals are fully licensed hospitals that meet a need not met by urgent care centers or freestanding emergency departments, neither of which offers inpatient care. Looking to fill a niche, micro-hospitals generally offer services in accordance with community needs.
Micro-hospitals have been described as “no-frills” facilities and are often positioned as a way to cut healthcare costs. At the same time, they offer patients the promise of a premium experience through personalized care. Industry experts claim that the smaller hospital format fosters patient satisfaction and better outcomes.
A Real House, Not a Warehouse, for Seniors
Seniors these days don’t want to live in what has been labeled as “geezer ghettos,” nor will they settle for institutional-looking living facilities. Increasingly, assisted living services are being offered in residential care facilities, located in converted homes with onsite or live-in caretakers and anywhere from two to 10 residents. They provide for a homey environment within a traditional neighborhood. Moreover, a smaller community and care-provider-to-resident ratio allow homes to cater to distinct needs and demographics, such as shared dietary restrictions or religious affiliations.
A new pilot project at The University of Southern Indiana is advancing the idea of “aging in community,” which recognizes that seniors who have special housing requirements don’t want to be segregated from the rest of society or warehoused in institutional settings. The MAGIC Project will create a multi-ability, multi-generational, inclusive community (MAGIC) housing model shared by college students and older adults. The project starts with a MAGIC Model House on or near campus and will eventually develop a model framework for building multi-generational, inclusive communities. The concept for a pod-type MAGIC community could be implemented on a university campus or in a community setting.
Downsizing in a Big Way
It wasn’t long ago that “bigger is better” was the prevailing trend in assisted living facility design. Between 2006 and 2009, the number of apartments in assisting living communities decreased from a nationwide average of 63 to 54, reflecting a practice of combining two units to accommodate residents who preferred larger living spaces. At that time, one-bedroom units surpassed studios as the preferred ALF floorplan, allowing residents to keep more of their belongings, which made them feel more at home.
A decade later, feeling “at home” may not hold the same appeal. A 2014 report from the Joint Center for Housing Studies at Harvard University found that the majority of seniors over 50 live in single-family suburban homes. And though the aging-in-place movement would have them stay there as long as possible, what happens in a lot of cases is seniors end up being stuck and isolated in large homes with yards they can no longer maintain, in car-dependent locations past the point when they can safely drive.
The need for accessibility and connectivity may drive a shift toward micro-apartments (generally under 400 square feet) in assisted living facilities located in urban or urbanist environments. Less space and stuff to take care of translates into more leisure time and, potentially, higher activity levels and more engagement. Aligning assisted living and micro-living makes sense not only in terms of engagement but also affordability.
Source: GlobeSt.
