December 20, 2018
Medicare Advantage plans continue to be an attractive option for the rapidly increasing senior population. As of November 2018, total Medicare Advantage (MA) membership stood at over 21.6 million, representing approximately 34% of the 63.7 million Americans eligible for Medicare. Health plan enrollment and market share data are important metrics for health insurers to assess in order to identify opportunities and make better business decisions about products and services. Companies not only look at their own market positions but also routinely analyze competitor membership to evaluate relative market share. Industry analysts often assess market share at the county or metropolitan statistical area (MSA) level in order to gain a more complete competitive picture of the market. This brief presents an overview of Medicare market demographics and market share data, with a focus on health plan market position for six major metropolitan statistical areas (MSAs) in the U.S.
Competition and Market Share
For the purposes of this brief, MFA first looked at the competitive mix in the Medicare and Medicare Advantage markets through analysis of enrollment figures from the Health Coverage Portal™ and Medicare Business Online™ by metropolitan areas in the United States. The following table presents the major metropolitan statistical areas (MSAs) with over a million seniors currently eligible for Medicare. These 6 areas represent the largest metropolitan markets in the country for companies offering Medicare Advantage plans.
|Metropolitan Area||Medicare Eligible||Original Medicare Enrollment||Medicare Advantage Enrollment|
|as of 11/1/18||as of 10/31/18||as of 11/1/18|
|New York-Newark-Jersey City||3,552,374||2,281,277||1,090,370|
|Los Angeles-Long Beach-Anaheim||2,047,525||983,059||976,559|
|Miami-Fort Lauderdale-West Palm Beach||1,150,689||477,777||615,645|
|Subtotal - Top MSAs||10,514,141||6,234,285||3,751,973|
|All Other MSAs||53,168,924||31,631,760||17,854,812|
|Medicare Advantage Enrollment||Medicare Advantage Market Share|
|Top Medicare Advantage Companies||as of 11/1/18||as of 11/1/18|
|New York-Newark-Jersey City|
|HEALTHFIRST HEALTHPLAN OF NJ||153,387||14.1%|
|Los Angeles-Long Beach-Anaheim|
|INDEPENDENCE BLUE CROSS||104,596||31.7%|
|Miami-Fort Lauderdale-West Palm Beach|
Eligibility, geographic location, income levels and overall health status of a population are just a few determinants of Medicare penetration in a particular area. While further demographic insight would be required to discern why Medicare and Medicare Advantage penetration is higher in some areas more than others, it is clear that the competitive mix among these MSAs indicates varying degrees of consumer choice. Nonetheless, the Medicare market continues to grow as more and more Americans of the Baby Boom generation enter retirement age. As always, Mark Farrah Associates will monitor enrollment trends and industry shifts in this highly competitive segment.
About Mark Farrah Associates (MFA)
Mark Farrah Associates (MFA) is a leading data aggregator and publisher providing health plan market data and analysis tools for the healthcare industry. MFA’s Medicare Business Online™ (MBO) product simplifies the tracking of monthly Medicare Advantage and PDP enrollment by competitor. The Medicare Benefits Analyzer™ presents benefit copay comparisons across hundreds of benefit attributes by plan as reported in the Plan Finder on Medicare.gov. Med Supp Market Data™ offers enrollment and financial insights for companies interested in Medicare Supplement business. Our product portfolio also includes Health Coverage Portal™ (with Supplemental Health Care Exhibit data), County Health Coverage™, and Health Plans USA™.
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