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Medicare Advantage, Managed Medicaid enrollment up while other segments decline, MFA report finds

Insurance Forums Staff

Health insurance enrollment trends continue to reflect noticeable shifts amidst the changing health care landscape, according to the latest Healthcare Business Strategy report from Mark Farrah Associates (MFA) comparing membership by segment between 1st quarter 2016 and 1st quarter 2017.

The latest trends indicate membership gains in Government programs, Medicare Advantage and Managed Medicaid, but year-over-year declines in the Individual/Non-Group, Employer Group Risk and Employer Group ASO (administrative services only) business segments.

Based on membership data filed with statutory financial reports from the NAIC (National Association of Insurance Commissioners), the CA DMHC (California Department of Managed Health Care), as well as data from MFA’s ASO estimates, insurance companies provided medical coverage for nearly 266 million people, as of March 31, 2017.

The Employer Group ASO and the Group Risk segments dominated in terms of total membership, covering 45% and 22% of the market, respectively. However, growth was most significant in the Managed Medicaid segment as membership increased by 2.8 million beneficiaries between 1Q16 and 1Q17. The following are key findings from MFA’s assessment of year-over-year first quarter enrollment trends:

• Medicare Advantage increased enrollment by over a million members, or 6% growth, between March 31, 2016 and March 31, 2017. First quarter membership in MA plans increased to over 19 million from 17.98 million in the prior year.

• Nearly 34% of the 58.5 million people eligible for Medicare are enrolled in MA plans across the United States and U.S. territories. Enrollment in Medicare Advantage is expected to continue to grow at a steady rate as more and more Americans of the Baby Boom generation are entering retirement.

• Approximately 18.1 million people are currently enrolled in Individual, Non-Group medical plans, representing an 11% decrease between 1Q16 and 1Q17.

• Managed Care Organizations (MCOs) now provide coverage for approximately 50.2 million beneficiaries, representing 6% growth, year-over-year. According to CMS reports, over 74.5 million people rely on Medicaid as their source of health insurance coverage as of April 2017.

• Employer Group Risk membership declined by 540,000 members, year-over-year.

• According to MFA’s recent estimates, Employer Group ASO membership was approximately 118.8 million, a decrease of nearly 158,000 members from March 2016 to March 2017.

Market analysts throughout the industry rely on enrollment data and segment performance metrics to gain better insights into health plan market share and competitive positioning. Mark Farrah Associates maintains financial data as well as enrollment and market share for the health insurance industry in its subscription-based Health Coverage Portal™. MFA will continue to monitor enrollment changes and competitive shifts across all healthcare segments.

To read the full text of “Health Insurance Enrollment Shifts and Market Segment Trends,” visit the Analysis Briefs library on Mark Farrah Associates’ website.

Source: Health Coverage Portal™, Mark Farrah Associates
Source: Health Coverage Portal™, Mark Farrah Associates

About Mark Farrah Associates (MFA): MFA is a leading data aggregator and publisher providing health plan market data and analysis tools for the healthcare industry. Committed to simplifying analysis of health insurance business, our products include Medicare Business Online™, Medicare Benefits Analyzer™, Health Coverage Portal™, County Health Coverage™, and Health Plans USA™



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