March 31, 2020
As of March 1, 2020, total Medicare Advantage
(MA), including Medicare Advantage with Prescription Drug Plan (MA-PD)
membership, stood at 24,750,719 with a net gain of 2,096,443 members from March
1, 2019. Medicare stand-alone prescription drug plans (PDPs) covered
25,194,944 members as of March 1, 2020, a net decrease of 364,857 from the
previous year. This brief assesses Medicare Advantage and PDP performance,
market share and market penetration by state as of March 1, 2020.
Medicare Advantage Membership
Medicare Advantage (MA) market penetration
remains strong; however, there is still abundant opportunity for growth with
only 36% of the 68.6 million people eligible for Medicare. According to
CMS Medicare Advantage enrollment reports aggregated by MFA in Medicare
Business Online™, total Medicare Advantage plan enrollment as of March 1, 2020
increased 9.3% from March 2019. The top ten companies, each with more
than 150,000 members in this segment, collectively provide coverage for 75.5%
of the market. Per the reference tables below, most leading MA companies
realized year-over-year growth with the exception of Centene. The overall
net gain for the ten companies was over 10%.
MA Leading Plan Performance
UnitedHealth continues to dominate in this highly competitive
segment. With approximately 6.35 million enrolled, UnitedHealth commands
25.7% of the Medicare Advantage market. Humana ranks second with 18%
market share and nearly 4.46 million lives. CVS maintains the third
position, enrolling over 2.6 million, and Kaiser Foundation Group follows with
over 1.68 million lives.
|
March 2020 Top
10 MA Organizations
|
||||
|
Parent
|
Mar-19
|
Mar-20
|
Percent Growth
|
March 2020 Market Share
|
|
UNITEDHEALTH
|
5,843,132
|
6,351,706
|
8.7%
|
25.7%
|
|
HUMANA
|
3,960,480
|
4,457,735
|
12.6%
|
18.0%
|
|
CVS
|
2,255,535
|
2,612,689
|
15.8%
|
10.6%
|
|
KAISER
|
1,633,597
|
1,681,235
|
2.9%
|
6.8%
|
|
ANTHEM
|
1,129,799
|
1,326,252
|
17.4%
|
5.4%
|
|
BCBS OF MI
|
520,824
|
591,631
|
13.6%
|
2.4%
|
|
WELLCARE
|
553,932
|
586,089
|
5.8%
|
2.4%
|
|
CIGNA
|
442,745
|
508,825
|
14.9%
|
2.1%
|
|
CENTENE
|
306,291
|
290,501
|
-5.2%
|
1.2%
|
|
HIGHMARK
|
279,762
|
285,142
|
1.9%
|
1.2%
|
|
Subtotal
Top 10
|
16,926,097
|
18,691,805
|
10.4%
|
75.5%
|
|
All Others
|
5,728,179
|
6,058,914
|
5.8%
|
24.5%
|
|
Total
|
22,654,276
|
24,750,719
|
9.3%
|
100.0%
|
|
Source: Medicare Business Online, Mark Farrah Associates,
presenting data from CMS enrollment reports
|
||||
The chart below indicates membership gains were considerable for
the leaders in this segment. UnitedHealth’s growth continues to raise the bar
for MA plan competition. UnitedHealth reported the largest increase in
membership, adding over 508,000 members year-over-year, for a net gain of
8.7%. Humana experienced the second largest gains with over 497,000 new
members. CVS and Anthem gained over 357,000 and 196,000 new members,
respectively.
|
MA
Organizations with the Largest Gains from March 2019 to March 2020
|
||||
|
Parent
|
Mar-19
|
Mar-20
|
Growth 2019-2020
|
Percent Change
|
|
UNITEDHEALTH
|
5,843,132
|
6,351,706
|
508,574
|
8.7%
|
|
HUMANA
|
3,960,480
|
4,457,735
|
497,255
|
12.6%
|
|
CVS
|
2,255,535
|
2,612,689
|
357,154
|
15.8%
|
|
ANTHEM
|
1,129,799
|
1,326,252
|
196,453
|
17.4%
|
|
BCBS OF MI
|
520,824
|
591,631
|
70,807
|
13.6%
|
|
CIGNA
|
442,745
|
508,825
|
66,080
|
14.9%
|
|
KAISER
|
1,633,597
|
1,681,235
|
47,638
|
2.9%
|
|
WELLCARE
|
553,932
|
586,089
|
32,157
|
5.8%
|
|
HEALTHFIRST
|
161,653
|
192,150
|
30,497
|
18.9%
|
|
SPECTRUM
HEALTH
|
151,718
|
177,990
|
26,272
|
17.3%
|
|
Total
|
16,653,415
|
18,486,302
|
1,832,887
|
11.0%
|
|
Source: Medicare Business Online, Mark Farrah Associates,
presenting data from CMS enrollment reports
|
||||
MA Individual and Group Enrollment
As of March 1, 2020, 81% of membership was
from individual MA policies with approximately 19.8 million enrolled
lives. UnitedHealth Group leads in this sector with nearly 5 million
members enrolled in individual MA plans. In contrast to direct purchase policies,
approximately 4.7 million members originated through an employer group health
plan or retirement health benefit as of March 2020. Enrollment in group
MA plans continues to grow as these plans allow employers to provide
comprehensive medical coverage and quality plan design at lower costs to senior
citizens. Group membership increased by 216,000 members as compared to the same
time period a year ago. Enrollment was primarily driven by UnitedHealth Group
with the company’s total employer-group membership at over 1.32 million.
CVS's group MA membership stood at 1.04 million, comprising 22% of group
enrollment as of March 1, 2020. Humana and Kaiser Foundation Group
continued to have more than 550,000 members from group plans.
It is important to
note that MA enrollment counts by company or geography for the same reporting
period may be slightly different, depending on the CMS enrollment source.
CMS county-level reports do not output enrollment for plans with 10 or fewer
members per county. There may likely be additional competitive shifts in
enrollment and market observations through March.
MA Plan Types
HMOs, including those with point-of-service
options, remain the dominant plan type. As of March 1, 2020, 14.7 million
of all MA members were enrolled in an HMO plan. PPOs, including local and
regional plans, covered approximately 9 million MA enrollees. Enrollment
for the Dual eligible population, or Medicare-Medicaid Plans (MMPs), stood at
over 378,000 as CMS and state Medicaid agencies continue to build new
programs. Private-fee-for-service (PFFS) and "Other" plan
types, including Cost or Medical Savings options, comprised 1.3% of all MA
members.
MA Enrollment Growth by State
As of March 1, 2020, Medicare Advantage
enrollment increased in all contiguous states. Overall, a net membership
gain of approximately 2.1 million was seen nationally. Florida, Texas,
California, Michigan, and New York all experienced significant enrollment gains
with increases of 100,000 members or more. Florida experienced the most
sizeable year-over-year increase of nearly 169,000 members.
Stand-alone Prescription Drug Plan Enrollment
Stand-alone prescription drug plans (PDPs),
also referred to as Medicare Part D stand-alone plans, enrolled nearly 25.2
million people as of March 1, 2020, a decrease of 364,857 enrollees from March
2019. PDP plans provide prescription drug coverage for nearly 37% of the
68.7 million people eligible for Medicare. Enrollment in products sold to
individuals was 20,243,444 in March 2020, a decrease of 330,467,
year-over-year. Only 4.56 million Medicare beneficiaries were
enrolled in employer group PDPs as of March 1, 2020, a decline of approximately
19,000 members since March 2019. It is important to note this assessment
is reporting on Stand-alone PDP members only, and Medicare Advantage with
prescription drug plan (MA-PD) members are not included in this analysis.
PDP Leading Plan Performance
There are currently 48 organizations competing in Medicare
stand-alone prescription drug plans (PDPs) as of March 2020. Six
companies have greater than 800,000 members and command 91% of the PDP
market. Five of these plans control 87% of the market covering 2 million
members or more. Per the chart below, CVS Group covers the largest number of
people in PDPs; however, CVS saw a 33.3% decrease in enrollment between March
2019 and March 2020 after selling Aetna’s PDP business to WellCare in 2019.
Consequently, WellCare experienced the most sizable percentage of
year-over-year enrollment growth with a 171.6% membership gain.
|
March
2020 Top PDP Organizations
|
||||
|
Parent
|
Mar-19
|
Mar-20
|
Percent Growth
|
March 2020 Market Share
|
|
CVS
|
8,519,821
|
5,681,399
|
-33.3%
|
22.5%
|
|
UNITEDHEALTH
|
5,159,930
|
4,847,038
|
-6.1%
|
19.2%
|
|
WELLCARE
|
1,626,264
|
4,416,776
|
171.6%
|
17.5%
|
|
HUMANA
|
4,339,785
|
3,779,400
|
-12.9%
|
15.0%
|
|
CIGNA
|
3,308,955
|
3,303,491
|
-0.2%
|
13.1%
|
|
ENVISION INS
|
634,499
|
879,524
|
38.6%
|
3.5%
|
|
Subtotal
|
23,589,254
|
22,907,628
|
-2.9%
|
90.9%
|
|
All Others
|
1,970,547
|
2,287,316
|
16.1%
|
9.1%
|
|
Total
|
25,559,801
|
25,194,944
|
-1.4%
|
100.0%
|
|
Source: Medicare Business Online, Mark Farrah Associates,
presenting data from CMS enrollment reports
|
||||
PDP Market Penetration by State
Stand-alone prescription drug plan enrollment
continued to experience a decrease in 36 states within the contiguous U.S.
including the District of Columbia as of March 1, 2020. Michigan had the
largest year-over-year aggregate decrease with over 34,000 fewer enrollees in
this segment. Maryland, with 547,267 members saw the most sizeable
increase of 8,931 more PDP enrollees from the previous year. Arizona
experienced the second highest enrollment gains with an increase of 5,385
members.
Conclusion
Health insurers continue to invest in MA and
PDP growth opportunities for increased enrollment, revenue and profits as the
number of people entering retirement increases each year. The Annual
Election Period (AEP) for Medicare Advantage (MA) and prescription drug plans
(PDPs) runs from October 15th through December 7th each
year. Health insurers compete by offering new pricing and product options
to beneficiaries during the AEP. Plans then begin to analyze final
enrollment results in February and March to evaluate their standing and assess
which competitors gained and lost members during the last AEP. Many
companies conduct their post-AEP competitive assessments by using tools such as
Mark Farrah Associates’ (MFA) Medicare
Business Online™ and Health Coverage Portal™. Health insurers
continue to invest in MA and PDP growth opportunities for increased enrollment,
revenue and profits as the number of people entering retirement increases each
year. Mark Farrah Associates will continue to monitor plan performance in
this highly competitive Medicare segment.
About this Data
This brief is based on an analysis of
enrollment data for Medicare Advantage and Prescription Drug Plans (PDPs)
released by the Centers for Medicare & Medicaid Services (CMS). Mark
Farrah Associates’ Medicare Business Online™ simplifies
the tracking of monthly Medicare Advantage and PDP enrollment by
competitor. Enrollment data is updated monthly as soon as CMS releases
new data. In addition to MFA’s Medicare Business Online™,
using MFA’s Medicare Benefits Analyzer, health companies
can compare and analyze 2020 benefit packages and develop strategies to offer
2021 products that will attract seniors while ensuring the company is not
adversely selected.
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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