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A Brief Look at Medicare Market Share for Six Major Metro Areas

Posted by www.psmbrokerage.com Admin on Fri, Dec 28, 2018 @ 12:36 PM

A Brief Look at Medicare Market Share for Six Major Metro Areas

By Mark Farrah Associates - December 21, 2018 

Medicare Advantage plans continue to be an attractive option for the rapidly increasing senior population.  As of November 2018, total Medicare Advantage (MA) membership stood at over 21.6 million, representing approximately 34% of the 63.7 million Americans eligible for Medicare.  Health plan enrollment and market share data are important metrics for health insurers to assess in order to identify opportunities and make better business decisions about products and services. 

Companies not only look at their own market positions but also routinely analyze competitor membership to evaluate relative market share.  Industry analysts often assess market share at the county or metropolitan statistical area (MSA) level in order to gain a more complete competitive picture of the market. 

This brief presents an overview of Medicare market demographics and market share data, with a focus on health plan market position for six major metropolitan statistical areas (MSAs) in the U.S. 

Competition and Market Share

For the purposes of this brief, MFA first looked at the competitive mix in the Medicare and Medicare Advantage markets through analysis of enrollment figures from the Health Coverage Portal™ and Medicare Business Online™ by metropolitan areas in the United States. 

The following table presents the major metropolitan statistical areas (MSAs) with over a million seniors currently eligible for Medicare. These 6 areas represent the largest metropolitan markets in the country for companies offering Medicare Advantage plans. 

Metropolitan Area

Medicare Eligible

Original Medicare Enrollment

Medicare Advantage Enrollment

 

as of 11/1/18

as of 10/31/18

as of 11/1/18

New York-Newark-Jersey City

3,552,374 

2,281,277 

1,090,370 

Los Angeles-Long Beach-Anaheim

2,047,525 

983,059 

976,559 

Chicago-Naperville-Elgin

1,584,461 

1,124,158 

382,515 

Philadelphia-Camden-Wilmington

1,172,678 

783,908 

329,888 

Miami-Fort Lauderdale-West Palm Beach

1,150,689 

477,777 

615,645 

Dallas-Fort Worth-Arlington

1,006,414 

584,106 

356,996 

 Subtotal - Top MSAs

10,514,141 

6,234,285 

3,751,973 

       

 All Other MSAs

53,168,924  

31,631,760  

17,854,812  

 Total

63,683,065  

37,866,045  

21,606,785 

Source: Medicare Business Online™, Mark Farrah Associates, presenting data from CMS enrollment reports 

Seniors have a choice between coverage offered by original Medicare and Medicare Advantage (MA).  While potential market size is an important metric, understanding the insurance preferences of seniors requires a closer look at enrollment within each area.  How seniors are behaving as consumers varies greatly among the metropolitan areas.  To shed more light on these differences, Mark Farrah Associates calculated the penetration rate for original Medicare & Medicare Advantage plans.  Penetration rate is calculated by dividing the number of plan members by the number of those eligible for Medicare. 

The penetration rate provides the overall market share which can be used to analyze seniors' choice between sticking with original Medicare and choosing a Medicare Advantage plan.

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Additional Updates:

 

Tags: Medicare Advantage, Medicare

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