April 29, 2020
As our country faces unprecedented times, health plans will most likely experience some form of disruption in many sectors of health insurance. Increasing efforts to improve health care delivery remain a primary goal of health insurers. In addition, health companies continue to make important decisions about investments in products and markets in order to withstand the impact of social and economic changes. 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 (MFA) assessed the latest year-over-year enrollment trends, comparing fourth quarter 2018 with fourth quarter 2019 segment membership based on data filed in statutory financial reports. Approximately 267.8 million people received medical coverage from U.S. health insurers as of December 31, 2019. This number is up from 265.7 million, or approximately 2.15 million additional members, from a year ago.
Based on data filed in statutory financial reports from the NAIC (National Association of Insurance Commissioners) and the CA DMHC (California Department of Managed Health Care), the Employer-group ASO (administrative services only for self-funded plans) and Employer-group risk segments together continue to be the largest source of coverage in the industry. However, membership growth was most significant in Medicare Advantage as this segment gained approximately 1.8 million more members, year-over-year. In contrast, the Individual, Non-group health insurance market and Managed Medicaid continued to suffer enrollment declines between 4Q18 and 4Q19.
The U.S. health insurance landscape continues to resonate with unpredictability. As health insurers are keeping a keen eye on the market as the country faces uncertainty, Mark Farrah Associates will monitor enrollment changes and competitive shifts across all healthcare segments.
About the Data
The data used in this analysis brief was obtained from Mark Farrah Associates' Health Coverage Portal™ database. It is important to note that MFA estimated fourth quarter 2019 enrollment for a small number of health plans that are required to report quarterly enrollment but hadn’t yet filed. Employer group ASO figures may be estimated by Mark Farrah Associates using credible company and industry resources. Individual, Non-group membership reported by some carriers may include CHIP (Children’s Health Insurance Program). These adjustments may have resulted in moderate understatement or overstatement of enrollment changes by segment. Findings reflect enrollment reported by carriers with business in the U.S. and U.S. territories. Data sources include NAIC (National Association of Insurance Commissioners) and the CA DMHC (California Department of Managed Health Care). As always, MFA will continue to report on important plan performance and competitive shifts across all segments.
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.
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