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Health Insurance Competition and Commercial Market Share in Three New York Metro Areas

 

February 20, 2020

 

Insurance companies provided medical coverage for approximately 267.9 million people as of September 30, 2019, based on enrollment as reported in Mark Farrah Associates’ County Health CoverageTM.  Of those with medical coverage, more than 196.2 million people were enrolled in a commercial healthcare plan. Considering the size of the commercial market, evaluating market share at the county and metropolitan statistical area is an important measure of competitive positioning and health plan performance for insurers. Commercial market share assessment at the county level can be difficult because insurance companies are generally not required to report local market membership except when mandated by state or federal regulation. In this brief, Mark Farrah Associates (MFA) analyzed enrollment figures from County Health CoverageTM  for three metropolitan statistical areas (MSAs) in New York with a focus on health plan market position.

Competition and Market Share

Approximately 13.3 million people were enrolled in a commercial healthcare plan in New York MSAs.  The graph below illustrates the leading companies in New York’s commercial health insurance market at the end of 3Q19. UnitedHealth, Anthem, and Lifetime Healthcare are the three largest health insurance companies in New York. 

 

 

The top three MSAs in New York, based on enrollment in commercial plans, include the New York City Metro Area, Rochester Metro Area, and the Albany Metro Area. For the purposes of this report, the New York City Metro Area includes data from counties in the state of New York and excludes those from New Jersey and Pennsylvania. The New York City metropolitan region has a population of over 12.6 million people according to the U.S. Census Bureau and is the largest MSA in the state based on population and commercial market size. The graph below shows market share as of 3Q19 of the top commercial market providers in the New York City MSA.  UnitedHealth and Anthem insure over 76% of the market.

 

 

 

Rochester is the second largest MSA in the state with a population of nearly 1.1 million people. Total commercial enrollment is nearly 718,000 and is dominated by Lifetime Healthcare with 77.5% of the market. MVP and CVS command 11.4% and 8.0% respectively.

 

 

The commercial market in Albany is the third largest in the state, insuring over 709,000 and includes the cities of Schenectady and Troy.  Albany has a smaller population than the Buffalo MSA; however, Albany has a larger commercial market. As illustrated in the chart below, based on MFA’s county estimates, CDPHP (Capital District Physicians’ Health Plan) Anthem, and Health Now are the commercial market leaders for the Albany MSA region. 

 

 

It is important to note that in some cases, estimates were based on enrollment reported by employer contract situs rather than state of member residence. 

About County Health Coverage TM

County Health Coverage™ provides reliable estimates of health insurance enrollment and market share at the state, county and metropolitan statistical area (MSA) level.  Product features include company market share by county, company and state for the Private Risk, Private ASO, Managed Medicaid, Medicare Advantage, and PDP segments.  Breakdowns by product type (HMO, PPO, etc.) are also presented as well as population demographics and interactive, visual mapping tools.  To learn more, visit the product page - County Health Coverage TM.

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.  Our product portfolio includes Health Coverage ™, County Health Coverage™, Medicare Business Online™, Medicare Benefits Analyzer™, and Health Plans USA™.  For more information about these products, refer to the informational videos and brochures available under the Our Products section of the website or call 724-338-4100.

Healthcare Business Strategy is a FREE monthly brief that presents analysis of important issues and developments affecting healthcare business today.  If you would like to be added to our email distribution list, please submit your email to the "Subscribe to MFA Briefs" section at the bottom of this page.

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