The 2016 OPEN MINDS Medicaid Managed Care Market Share Report
Managed care is the dominant Medicaid contracting model with 68.8% of the 75 million Medicaid enrollees receiving services through an at-risk managed care organization (MCO). In states with managed care, the Medicaid program generally contracts with a mixture of local and national private organizations to provide managed care services. As a result there are more than 200 organizations that provide managed care services. Despite the large number of health insurers, a small number of health insurers are responsible for covering the majority of Medicaid enrollees. The top ten Medicaid health insurers by enrollment cover about 29 million consumers and account for 55.2% of the market share.
Understanding the Medicaid market and the dominant contractors is crucial to provider organizations who are either looking to expand their geographic service or looking for increased managed care contracting opportunities. This report discusses those top ten plans and includes the following information:
- An overview of the Medicaid landscape including total Medicaid enrollment over time and managed care enrollment over time
- The ten largest Medicaid health plans and their enrollment in the first quarter of 2016
- A profile of each of the largest insurers including their revenue and geographic availability