Private Payers News

SCAN Health Plan Announces Medicare Advantage Expansion into TX

The payer’s executives stated that local providers with similar objectives invited the payer to enter the markets in Texas.

SCAN Health Plan, Medicare Advantage, patient-centered care, Medicare

Source: Getty Images

By Kelsey Waddill

- SCAN Health Plan (SCAN) announced it will be extending Medicare Advantage plans into Texas and new counties in Nevada in 2023.

“As SCAN continues to grow and build its national reputation as a leader in senior healthcare, our unique approach to provider relationships enables us to deliver quality care and service for older adults that stands out among the rest,” Karen Schulte, senior vice president of network management at SCAN, said in the press release.

The payer stated that it intends to enter the Medicare Advantage markets in Harris County, Texas and Bexar County, Texas, marking its entrance into the state of Texas.

SCAN already has plans in Nevada, but the payer wants to extend its reach in the Silver State. SCAN announced its intent to enter the Nye County Medicare Advantage market.

SCAN’s expansion has to receive approval from CMS before it can go any further. However, if the agency does affirm the payer’s plans, then SCAN’s membership could swell to around 7 million. The payer would have health insurance products in 20 markets in five states.

Leaders from within the payer organization said that the payer was asked to enter these markets. Schulte explained that health systems and medical groups invited the payer into their counties. The providers that extended the invitation shared the payer's patient-centered care approach. 

“SCAN values building strong, long-standing relationships with its provider partners that translate into improved care for our members,” Schulte added. “As SCAN and its reputation continue to grow, it garners the attention of potential partners across the country who align with our mission to keep seniors healthy and independent.”

The press release shared that these expansions fit within the payer’s larger vision.

“SCAN is on a trajectory of rapid growth,” said Sachin Jain, MD, president and chief executive officer of SCAN Group and SCAN Health Plan. “With the record-breaking AEP season we experienced last year, we are keenly aware of what older adults are looking for in their Medicare Advantage plan—and we are poised to deliver.”

The announcement follows news that the payer’s parent organization, SCAN Group, acquired The Residentialist Group (TRG), an organization that specializes in home healthcare. In this acquisition, the payer aimed to expand make more efficient its existing home healthcare services. TRG and SCAN Group’s home healthcare program, HealthCHEC, will merge to become Homebase Medical.

Some payers have also announced expansions in the past year. Humana extended its Medicare Advantage products into Tennessee in 2022 with a dual special needs Medicare Advantage plan. The payer also expanded its home healthcare program, onehome, in order to offer greater access to care for Medicare Advantage members. Humana expanded onehome into the cities of Richmond and Roanoke in Virginia and southern Virginia.

Other payers have expanded their Medicare Advantage benefits. Cigna responded to the heat wave by expanding the payer’s Medicare Advantage transportation benefit. The move allows seniors to leverage the non-emergency transportation benefit for free in order to travel to areas with air conditioning.

Studies show that Medicare Advantage plans are accounting for a higher share of enrollment in 2022, compared to fee-for-service Medicare and alternative Medicare coverage.