November 30, 2023
With the Public Health Emergency finally over and redeterminations for coverage in process, many managed care companies that participate in Managed Medicaid markets are reporting declines in enrollment, after years of unprecedented growth in the segment. Managed Medicaid enrollment peaked in March of 2023 and is down 5.5% since then. These carriers provide coverage for 74.5 million people, as of September 2023, down from 75.6 million people, as of September 2022, year-over-year. In this Business Strategy Report, utilizing information from its Health Coverage Portal™, Mark Farrah Associates (MFA) examines how carriers in the Managed Medicaid segment have fared between the third quarter of 2022 (3Q22) to the third quarter of 2023 (3Q23).
During the Public Health Emergency (PHE), redeterminations for Medicaid eligibility were suspended. Now that the PHE is over, State Departments of Health and Human Services across the country have enacted various processes and timetables to evaluate millions of Medicaid beneficiaries’ eligibility for services. The varying timetables are impacting Medicaid managed care organizations at different rates.
Two of the top ten leading plans, Local Initiative Health for Los Angeles County and Inland Empire Health Plan, both located in California, reported the largest percentage increases in membership between 3Q22 and 3Q23, at 5.7% and 5.1%, respectively. California began disenrolling people, no longer eligible for Medicaid, on July 1, 2023, and the state’s full redetermination process is expected to take more than a year to complete. Other states began earlier and are taking a faster approach to complete all redeterminations.
Molina also reported a year-over-year increase of nearly 79,000 Medicaid members, or 1.8%. This is primarily due to a new contract in Iowa, offset by losses elsewhere. Centene experienced the largest membership decline, shedding over 689,000 enrollees, representing a -4.7% decline year-over-year. Most of Centene’s enrollment losses came from Florida and New York, somewhat offset by gains in California. The table below illustrates the results for the top 10 companies, in September of 2023.
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 Portal™, County Health Coverage™, Medicare Business Online™, Medicare Benefits Analyzer™, 5500 Employer Health PLUS, 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.
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