Blog

Quarterly Medicaid Managed Care Enrollment Update – Q1 2017

This week, we reviewed recent Medicaid enrollment trends in capitated, risk-based managed care in 25 states.[1] Many state Medicaid agencies elect to post monthly enrollment figures by health plan for their Medicaid managed care population to their websites. This data allows for the timeliest analysis of enrollment trends across states and managed care organizations. Nearly all 25 states have released monthly Medicaid managed care enrollment data through the first quarter (Q1) of 2017. This report reflects the most recent data posted.

Seventeen of the 25 states in Table 1 (below) – Arizona, California, Hawaii, Illinois, Indiana, Iowa, Kentucky, Louisiana, Maryland, Michigan, Minnesota, New Mexico, New York, Ohio, Pennsylvania, Washington, and West Virginia – expanded Medicaid under the Affordable Care Act and have seen increased Medicaid managed care enrollment as a result of expansion.

  • The 25 states in this report account for an estimated 48 million Medicaid managed care enrollees as of the end of Q1 2017. Based on HMA estimates of MCO enrollment in states not covered in this report, we believe that, nationwide, Medicaid MCO enrollment has surpassed 54 million in the first quarter of 2017. As such, the enrollment data across these 25 states represents close to 90 percent of all Medicaid MCO enrollment.
  • Across the 25 states tracked in this report, Medicaid managed care enrollment is up 4.9 percent year-over-year as of March 2017, adding more than 2.2 million net new enrollees since March 2016.
  • The seventeen expansion states listed above have seen net Medicaid managed care enrollment increase by nearly 2.1 million members, or 6.2 percent, in the past year, to 35.3 million members at the end of Q1 2017.
  • The eight states that have not yet expanded Medicaid have seen net Medicaid managed care enrollment increase by roughly

Table 1 – Monthly MCO Enrollment by State – October 2016 through March 2017

Note: In Table 1 above and the state tables below, “+/- m/m” refers to the enrollment change from the previous month. “% y/y” refers to the percentage change in enrollment from the same month in the previous year.

Below, we provide a state-specific analysis of recent enrollment trends in the states where HMA tracks data.

It is important to note the limitations of the data presented. First, not all states report the data at the same time during the month. Some of these figures reflect beginning-of-the-month totals, while others reflect an end-of-the-month snapshot. Second, in some cases the data is comprehensive in that it covers all state-sponsored health programs for which the state offers managed care; in other cases, the data reflects only a subset of the broader managed Medicaid population. This is the key limiting factor in comparing the data described below and figures reported by publicly traded Medicaid MCOs. Consequently, the data we review in Table 1 and throughout the In Focus section should be viewed as a sampling of enrollment trends across these states rather than a comprehensive comparison, which cannot be developed based on publicly available monthly enrollment data.

State-Specific Analysis

Arizona

Medicaid Expansion Status: Expanded January 1, 2014

Enrollment in Arizona’s two Medicaid managed care programs has seen growth in Q3 2016 and into Q1 2017, adding a net 24,600 members. At the end of Q1 2017, Arizona’s MCO enrollment stands at nearly 1.62 million, up 3.6 percent year-over-year.

California

Medicaid Expansion Status: Expanded January 1, 2014

Medi-Cal managed care enrollment data through March 2017 shows an overall trend of enrollment growth, with membership up more than 260,000 over the last six months. As of March 2017, enrollment in managed care is approximately 10.85 million, a 4 percent increase over the previous year.

Florida

Medicaid Expansion Status: Not Expanded

Florida’s statewide Medicaid managed care program covers just over 3.4 million beneficiaries as of March 2017, up 2.3 percent from the prior year. (Note that the managed LTC enrollment figures listed below are a subset of the Managed Medical Assistance (MMA) enrollments and are included in the MMA number; they are not separately added to the total to avoid double counting).

Georgia

Medicaid Expansion Status: Not Expanded

As of January 2017, Georgia Medicaid managed care enrollment stands at nearly 1.3 million, down 1 percent from a year prior. Georgia has not reported enrollment figures for February or March as of publication.

Hawaii

Medicaid Expansion Status: Expanded January 1, 2014

Through December 2016, enrollment in the Hawaii Medicaid managed care program stands at more than 356,000, up 3.8 percent from Q4 2015. Hawaii has not reported Q1 2017 enrollment figures at the time of publication.

Illinois

Medicaid Expansion Status: Expanded January 1, 2014

Illinois enrollment across the state’s four managed care programs sits at just under 2 million as of March 2017, down 3.5 percent from March 2016. In the third quarter of 2016, Illinois began enrolling dual eligible members who opt out of the duals demonstration in mandatory Managed Long Term Supports and Services (MLTSS) in the Greater Chicago region, with more than 27,000 members now enrolled.

Indiana

Medicaid Expansion Status: Expanded in 2015 through HIP 2.0

As of January 2017, enrollment in Indiana’s managed care programs—Hoosier Healthwise, Hoosier Care Connect, and Healthy Indiana Program (HIP)—has surpassed 1.1 million, up 5.8 percent from the prior year.

Iowa

Medicaid Expansion Status: Expanded January 1, 2014

Iowa launched its new statewide Medicaid managed care program in April of 2016. Enrollment across all populations sits at more than 618,000 as of January 2017. Enrollment data for February and March are not available as of the time of publication.

Kentucky

Medicaid Expansion Status: Expanded January 1, 2014

As of December 2016, Kentucky enrolled more than 1.2 million beneficiaries in risk-based managed care. Total enrollment is effectively flat from a year prior.

Louisiana

Medicaid Expansion Status: Expanded July 1, 2016

Medicaid managed care enrollment in Bayou Health stands at more than 1.46 million as of March 2017, up 35 percent from the previous year. Louisiana’s Medicaid expansion began on July 1, 2016, and is the major driver of MCO enrollment growth since Q3 2016.

Maryland

Medicaid Expansion Status: Expanded January 1, 2014

Maryland’s Medicaid managed care enrollment has shown steady growth over the past year, with March 2017 enrollment coming in at more than 1.15 million, up 11.1 percent from the prior year.

Michigan

Medicaid Expansion Status: Expanded April 1, 2014

Michigan’s Medicaid and CHIP managed care growth trends over the past year have continued into 2017. As of March 2017, managed care enrollment has surpassed 1.8 million, up 5.8 percent from the previous year.

Minnesota

Medicaid Expansion Status: Expanded January 1, 2014

As of March 2017, enrollment across Minnesota’s multiple managed Medicaid programs sits at more than 906,000, up 14 percent from the prior year.

Mississippi

Medicaid Expansion Status: Not Expanded

MississippiCAN, the state’s Medicaid managed care program, grew significantly in 2015. However, net enrollment declines over the past year have reversed some of this growth. Medicaid managed care membership stands at more than 489,000 as of February 2017, down 3.4 percent from last year.

Missouri

Medicaid Expansion Status: Not Expanded

Missouri managed care enrollment in the Medicaid and CHIP programs sits at more than 507,000 as of December 2016. Although the state has not expanded Medicaid, Missouri has seen steady growth in managed care membership, with end of 2016 enrollment up 6.5 percent from the previous year. Missouri is set to expand Medicaid managed care geographically in the coming months.

New Mexico

Medicaid Expansion Status: Expanded January 1, 2014

As of March 2017, the New Mexico’s Centennial Care program enrolls more than 700,000 members, with steady enrollment growth throughout 2016 and into 2017, a 5.2 percent increase over the prior year.

New York

Medicaid Expansion Status: Expanded January 1, 2014

New York’s Medicaid managed care programs collectively enrolled just under 4.66 million beneficiaries as of March 2017, roughly flat from the previous year.

Ohio

Medicaid Expansion Status: Expanded January 1, 2014

As of March 2017, enrollment across all four Ohio Medicaid managed care programs has surpassed 2.5 million, up 3.3 percent from the prior year.

Pennsylvania

Medicaid Expansion Status: Expanded as of 2015

Midway through the first quarter of 2017, Pennsylvania’s Medicaid managed care enrollment sits at nearly 2.3 million, up 5.4 percent in the past year.

South Carolina

Medicaid Expansion Status: Not Expanded

South Carolina’s Medicaid managed care programs saw steady growth which has largely continued into 2017. March 2017’s 770,000 members represent 7.1 percent growth in the past year.

Tennessee

Medicaid Expansion Status: Not Expanded

As of March 2017, TennCare managed care enrollment totaled 1.48 million, down 3 percent from the prior year. The past six months have seen net enrollment decline by more than 70,000 members.

Texas

Medicaid Expansion Status: Not Expanded

Enrollment reporting out of Texas has been limited in the past six months. As of November 2016, Texas managed care enrollment stands at more than 3.93 million across the state’s six managed care programs, having launched STAR KIDS in the second half of 2016. November 2016 enrollment is up 1.6 percent from the prior year.

Washington

Medicaid Expansion Status: Expanded January 1, 2014

Washington’s Medicaid managed care enrollment as of March 2016 stands a little over 1.6 million. This represents a 6.5 percent increase from the prior year.

West Virginia

Medicaid Expansion Status: Expanded January 1, 2014

As of March 2017, West Virginia’s managed care program enrolls roughly 380,000 members, up just 1.4 percent year-over-year. Overall Medicaid MCO enrollment has declined by nearly 10,000 members in the past six months.

Wisconsin

Medicaid Expansion Status: Not Expanded

Across the state’s three managed care programs, March 2017 enrollment totals nearly 800,000, down 1 percent from the year before.

More Information Available from HMA Information Services

More detailed information on the Medicaid managed care landscape is available from HMA Information Services (HMAIS), which  collects Medicaid enrollment data, health plan financials, and the latest on expansions, waivers, duals, ABD populations, long-term care, accountable care organizations, and patient-centered medical homes. There is also a public documents library with copies of Medicaid RFPs, responses, model contracts, and scoring sheets.

HMA enhances this publicly available information with an overview of the structure of Medicaid in each state, as well as a proprietary HMA Medicaid Managed Care Opportunity Assessment.

For additional information on how to subscribe to HMA Information Services, contact Carl Mercurio at 212-575-5929 or cmercurio@healthmanagaement.com.

[1] Arizona, California, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Kentucky, Louisiana, Maryland, Michigan, Minnesota, Mississippi, Missouri, New Mexico, New York, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Washington, West Virginia, Wisconsin.

Leave a Comment

Get the free
HMA Weekly
Roundup

Subscribe