Health Plan Enrollment Shifting Toward Government-Sponsored Programs
KENNEBUNK, Maine -- January 30, 2013
Enrollment gains in government-sponsored health insurance business for the top
seven health plans in the nation have out-paced gains in Commercial business
according to a new report by Mark Farrah Associates (MFA). In fact, MFA found
that for every Commercial member gained, the top plans added nearly five in
government-sponsored programs. As growth in the Commercial segment staggers,
with a poor prognosis for recovery in the near future, many of the leading
plans’ corporate strategies call for pursuing more business in the Senior and
Medicaid segments. Acquisitions of companies specializing in these segments
have been prevalent among top plans.
Total medical membership for the leading U.S. health insurance plans increased
2.6% from 128.3 million as of September 2011 to 131.7 million as of September
2012. Overall, Commercial business increased by 1.0% from September 2011 to
September 2012. Medicare and Medicaid enrollment increased 17.2% and 6.2%
respectively during the same period. Enrollment in administrative services
only (ASO) funding arrangements grew year-over-year and enrollment in
fully-insured (Risk) business declined during the period. Primarily all of the
Commercial sector growth is from ASO business. Profitability saw a slight
downturn for the majority of leading health plans for the first nine months of
2012 when compared to the first nine months of 2011. Top health plan
profitability was impacted by several factors from shifts to lower margin ASO
and government-sponsored businesses, to increased administrative costs due to
acquisitions, to implementation of health reform regulations.
In the latest Healthcare Business Strategy report, MFA reviewed enrollment and
financial trends for Aetna, Cigna, Health Care Service Corporation (HCSC),
Humana, Kaiser Permanente, UnitedHealth Group and WellPoint. Membership data,
financial statistics and observations were gleaned from the January 2013
Health Insurer Insights™ series, a Mark Farrah Associates publication. To read
the full text of “Health Plan Enrollment Shifting Toward Government-Sponsored
Programs," visit the Analysis Briefs library on Mark Farrah Associates'
About Mark Farrah Associates (MFA)
MFA is a leading data aggregator and publisher providing health plan market
data and analysis tools for the healthcare industry. Committed to simplifying
analysis of health insurance business, our products include Health Coverage
Portal™, County Health Coverage™, Health Insurer Insights™, Medicare Business
Online™, Medicare Benefits Analyzer™ and Health Plans USA™.
Mark Farrah Associates
Debra Donahue, 207-985-8484
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