March 31, 2021
Health insurers compete by offering new pricing and product
options to beneficiaries during the Open Enrollment Period for Medicare
Advantage (MA) and prescription drug plans (PDPs), that runs from October 15th through
December 7th of each year. Plans then begin to analyze final
enrollment results in February and March to evaluate their standing and assess
which competitors gained and lost members. As of March 1, 2021, total
Medicare Advantage (MA), including Medicare Advantage with Prescription Drug
Plan (MA-PD) membership, stood at 27,158,911 with a net gain of 2,408,192 members
from March 1, 2020. Medicare stand-alone prescription drug plans (PDPs)
covered 24,268,611 members as of March 1, 2021, a net decrease of 926,333 from
the previous year. This brief assesses Medicare Advantage and PDP performance,
market share and market penetration by state as of March 1, 2021.
Medicare Advantage (MA) Membership
Medicare Advantage (MA) market penetration remains strong;
however, there is still abundant opportunity for growth with only 43% of the
nearly 63 million people eligible for Medicare enrolled in a MA plan.
According to CMS Medicare Advantage enrollment reports aggregated by Mark
Farrah Associates (MFA) in Medicare Business Online™, total Medicare Advantage
plan enrollment as of March 1, 2021 increased 9.7% from March 2020. The
top ten companies, each with more than 250,000 members in this segment,
collectively provided coverage for almost 78% of the market. Per the
reference tables below, all leading MA companies realized year-over-year growth
with an overall net gain of 11.2%.
MA Leading Plan Performance
UnitedHealth continues to dominate in this highly competitive
segment. With approximately 7.2 million enrolled, UnitedHealth commands
26.6% of the Medicare Advantage market. Humana ranks second with 18%
market share and over 4.8 million lives. CVS maintains the third
position, enrolling over 2.8 million, and Kaiser Foundation Group follows with
over 1.7 million lives.
|
March 2021 Top
10 MA Organizations |
||||
|
Parent |
Mar-20 |
Mar-21 |
Percent Growth |
March
2021 Market Share |
|
UNITEDHEALTH |
6,351,706 |
7,221,432 |
13.7% |
26.6% |
|
HUMANA |
4,457,735 |
4,854,260 |
8.9% |
17.9% |
|
CVS |
2,620,469 |
2,860,379 |
9.2% |
10.5% |
|
KAISER |
1,681,235 |
1,740,733 |
3.5% |
6.4% |
|
ANTHEM |
1,326,780 |
1,530,894 |
15.4% |
5.6% |
|
CENTENE |
868,282 |
1,136,875 |
30.9% |
4.2% |
|
BCBS MI |
591,631 |
608,534 |
2.9% |
2.2% |
|
CIGNA |
508,825 |
568,270 |
11.7% |
2.1% |
|
HIGHMARK |
285,142 |
287,158 |
0.7% |
1.1% |
|
INNOVACARE |
263,349 |
272,421 |
3.4% |
1.0% |
|
Subtotal |
18,955,154 |
21,080,956 |
11.2% |
77.6% |
|
All Others |
5,795,565 |
6,077,955 |
4.9% |
22.4% |
|
Total |
24,750,719 |
27,158,911 |
9.7% |
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 approximately 870,000 members year-over-year, for a net gain
of 13.7%. Humana experienced the second largest gains with over 396,000
new members. Centene and CVS gained over 268,000 and 239,000 new members,
respectively. Centene’s growth of nearly 31% clearly stands out amongst
the segment leaders.
|
MA Organizations
with the Largest Gains from March 2020 to March 2021 |
||||
|
Parent |
Mar-20 |
Mar-21 |
Growth
2020-2021 |
Percent Change |
|
UNITEDHEALTH |
6,351,706 |
7,221,432 |
869,726 |
13.7% |
|
HUMANA |
4,457,735 |
4,854,260 |
396,525 |
8.9% |
|
CENTENE |
868,282 |
1,136,875 |
268,593 |
30.9% |
|
CVS |
2,620,469 |
2,860,379 |
239,910 |
9.2% |
|
ANTHEM |
1,326,780 |
1,530,894 |
204,114 |
15.4% |
|
KAISER |
1,681,235 |
1,740,733 |
59,498 |
3.5% |
|
CIGNA |
508,825 |
568,270 |
59,445 |
11.7% |
|
SPECTRUM HEALTH |
177,990 |
202,466 |
24,476 |
13.8% |
|
BCBS MN |
146,232 |
164,920 |
18,688 |
12.8% |
|
HEALTHFIRST |
192,150 |
210,402 |
18,252 |
9.5% |
|
Total |
18,331,404 |
20,490,631 |
2,159,227 |
11.8% |
|
Source: Medicare Business Online, Mark
Farrah Associates, presenting data from CMS enrollment reports |
||||
MA Individual and Group Enrollment
As of March 1, 2021, 82% of membership was from individual MA
policies with approximately 22 million enrolled lives. UnitedHealth Group
consistently leads in this sector with over 5.6 million members enrolled in
individual MA plans. In addition to direct purchase policies, nearly 5
million members originated through an employer group health plan or retirement
health benefit. 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 for retirees. Group membership increased by
approximately 281,000 members as compared to the same period a year ago.
UnitedHealth grew their group enrollment by approximately 187,000, driving the
company’s total employer-group membership to over 1.5 million. CVS's
group MA membership stood at 1.1 million, comprising 22.6% of group enrollment
as of March 1, 2021. Humana and Kaiser Foundation Group had more than
540,000 members each from group plans.
MA Plan Types
HMOs, including those with point-of-service options, remain the
dominant plan type. As of March 1, 2021, 15.9 million of all MA members
were enrolled in an HMO plan. PPOs, including local and regional plans,
covered approximately 10.3 million MA enrollees. Enrollment for the dual-eligible
population, or Medicare-Medicaid Plans (MMPs), stood at over 389,000 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 1.4% of all MA members.
MA Enrollment Growth by State
As of March 1, 2021, Medicare Advantage enrollment increased in
all contiguous states. Overall, a net membership gain of nearly 2.4
million was seen nationally. Texas, California, Florida, and Michigan all
experienced significant enrollment gains with increases of 100,000 members or
more. Texas experienced the most sizeable year-over-year increase of
nearly 208,000 members.
Stand-alone Prescription Drug Plan (PDP) Enrollment
Stand-alone prescription drug plans (PDPs), also referred to as
Medicare Part D stand-alone plans, enrolled approximately 24.3 million people
as of March 1, 2021, reflecting a significant decrease of roughly 926,000
enrollees from March 2020. PDP plans provide prescription drug coverage
for nearly 38% of the 63 million people eligible for Medicare. Enrollment
in products sold to individuals was almost 19.5 million in March 2021, a
decrease of 773,236, year-over-year. Only 4.4 million Medicare
beneficiaries were enrolled in employer group PDPs as of March 1, 2021, after a
decline of approximately 145,444 members since March 2020. 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 51 organizations competing in Medicare
stand-alone prescription drug plans as of March 2021. Five companies have
greater than 2,000,000 members and command 87% of the PDP market. As
indicated in the chart below, CVS Group, the only top plan to experience
membership gains, covers the largest number of people in PDPs and saw a small
enrollment increase of 1% between March 2020 and March 2021.
|
March 2021 Top
PDP Organizations |
||||
|
Parent |
Mar-20 |
Mar-21 |
Percent Growth |
March
2021 Market Share |
|
CVS |
5,681,399 |
5,738,786 |
1.0% |
23.6% |
|
UNITEDHEALTH |
4,847,038 |
4,507,985 |
-7.0% |
18.6% |
|
CENTENE |
4,416,776 |
4,131,374 |
-6.5% |
17.0% |
|
HUMANA |
3,779,400 |
3,556,348 |
-5.9% |
14.7% |
|
CIGNA |
3,303,491 |
3,194,589 |
-3.3% |
13.2% |
|
Subtotal |
22,028,104 |
21,129,082 |
-4.1% |
87.1% |
|
All Others |
3,166,840 |
3,139,529 |
-0.9% |
12.9% |
|
Total |
25,194,944 |
24,268,611 |
-3.7% |
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 decreases in 45 states within the contiguous U.S. including the
District of Columbia as of March 1, 2021. Texas had the largest
year-over-year aggregate decrease with over 67,000 fewer enrollees in this
segment. Alaska, with 66,891 members saw the most sizeable increase of
3,087 more PDP enrollees from the previous year. South Dakota experienced
the second highest enrollment gains with an increase of 2,395 members.
Conclusion
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.
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.
Many companies conduct their post-OEP 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 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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