UnitedHealthcare Dominates as Managed Duals Market Continues to Grow

The number of Medicare-Medicaid dual eligibles enrolled in managed care plans topped 3.6 million as of December 2020 — a 15% boost from December 2019 — according to the latest data release from CMS and AIS's Directory of Health Plans. More than 85% of managed duals are enrolled in Dual Eligible Special Needs Plans (D-SNPs) or Fully Integrated Dual Eligible Special Needs Plans (FIDE-SNPs), which have become more prevalent as payers seek to grow their Medicare Advantage markets and as states work to better integrate Medicare and Medicaid benefits. In addition, 10 states continue to work with CMS on localized duals coordination, operating Medicare-Medicaid Plans under the capitated model of the Financial Alignment Initiative. The 10 largest duals sponsors have a tight grip on the market, enrolling 2.7 million lives, with UnitedHealthcare alone holding 30.6% of national market share. Below, see a breakdown of the current duals landscape, plus the top 10 duals sponsors with their enrollment changes from 2019.

 

*2020 enrollment data includes Centene Corp.'s completed acquisition of WellCare Health Plans, Inc.
SOURCE: CMS; DHP, AIS's Directory of Health Plans. Visit https://aishealthdata.com/dhp for more information