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Trends in Employer Group Medicare Advantage Enrollment

 

November 14, 2019

As of October 1, 2019, more than 23 million people were enrolled in Medicare Advantage (MA) plans, representing a growing share of the 67.1 million Americans eligible for Medicare. Individual MA policies, acquired through direct purchase policies, have historically dominated the MA market as 18.5 million beneficiaries purchased individual plans as of October 1, 2019. Concurrently, employer group retiree programs known as Medicare Advantage Employer Group Waiver Plans (MA-EGWP) experienced a steady increase in enrollment to nearly 4.5 million enrollees, or 19.5% of all MA plans. Employer group MA enrollment has increased by almost 321,000, a 7.7% increase, since December 2018. Moreover, group market enrollment has increased by approximately 1.3 million members since December 2016. In this brief, Mark Farrah Associates (MFA) compares the latest employer group MA enrollment reports with recent year-end enrollment reports from the Centers for Medicare and Medicaid Services (CMS) as aggregated in Medicare Business Online™.

 

 

Enrollment Trends by Carrier and State

The top 5 carriers of group Medicare Advantage measured by enrollment have remained unchanged over the past few years, despite increasing competition within this market segment.  As of October 2019, UnitedHealth persisted as the largest provider with nearly 1.4 million members. CVS/Aetna grew 31.5% from December 2018 to October 2019 in large part due to an increase in enrollment across all counties in New Jersey. Kaiser continues to command a sizable share of the employer group MA market with over 550,000 members. Lastly, Humana and BCBS of Michigan rounded out the top companies with nearly 511,000 and 379,000 members, respectively.

 

Top 5 Medicare Advantage Payers - Group Segment
Membership Trend
 Company  Dec-16  Dec-17  Dec-18  Oct-19
 UnitedHealth 789,377  1,148,615  1,295,804  1,387,052 
 CVS/Aetna 563,938  547,618  694,752  913,490 
 Kaiser 486,115  525,711  538,304  550,331 
 Humana 341,926  428,240  484,402  510,956 
 BCBS of Michigan 302,207  318,675  371,745  378,890 
 Total  2,483,563  2,968,859  3,385,007  3,740,719 
                                   Source: Medicare Business OnlineTM, Mark Farrah Associates, presenting data from CMS enrollment reports

 

All 5 of the leading group MA health plans achieved double-digit growth in membership since December 2016. UnitedHealth added nearly 598,000 enrollees since December 2016, an increase of 76%. CVS/Aetna experienced the second largest growth rate of 62% since December 2016, with a gain of 350,000 members. Overall, the top five companies gained nearly 1.3 million beneficiaries equating to a 51% enrollment increase since 2016.  While not in the top 5, Anthem experienced triple digit growth since December 2016, growing to 152,000 members in October 2019, mainly from enrollment in California and Colorado.

 

Top 10 States Medicare Advantage - Group Segment
Membership Trend
 State  Dec-16  Dec-17  Dec-18  Oct-19
 CA 522,411  552,221  588,811  622,404 
 MI 315,917  333,653  392,191  405,415 
 TX 211,098  244,097  315,669  323,527 
 NY 221,630  250,598  263,598  270,410 
 OH 191,397  204,936  235,889  238,235 
 PA 201,425  216,773  218,481  223,319 
 IL 162,023  189,044  198,894  204,825 
 NJ 58,434  117,771  122,375  199,765 
 NC 139,685  154,050  178,491  189,769 
 FL 110,619  139,670  163,111  179,147 
Subtotal  2,134,639  2,402,813  2,677,510  2,856,816 
 All Other States 1,078,922  1,298,878  1,468,865  1,610,196 
Total  3,213,561  3,701,691  4,146,375  4,467,012 
                                    Source: Medicare Business OnlineTM, Mark Farrah Associates, presenting data from CMS enrollment reports

 

Between December 2016 and October 2019, the United States and territories experienced a 39% overall growth rate in group MA market enrollment. While markets vary by state, trends mostly show gains in penetration since 2016. All the leading ten states by enrollment experienced membership increases with California topping the list at over 622,000 members. New Jersey experienced the largest percentage increases since December 2016 partly due to CVS/Aetna gains within the state.

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™, 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 in the grey area at the bottom of the page. 

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