The 2017 OPEN MINDS Medicaid Managed Care Market Share Report

Managed care is the dominant Medicaid contracting model, with 70.1% of the country’s total number of Medicaid enrollees receiving services through an at-risk managed care organization (MCO) in 2017. In states with Medicaid managed care, the program generally contracts with a mixture of local and national private organizations to provide managed care services. Understanding the Medicaid market and the dominant contractors are crucial to provider organizations who are either looking to expand their geographic service or are looking for increased managed care contracting opportunities.

In 2017, there were 190 health insurers with Medicaid managed care programs. Despite the large number of health insurers, a small number of health insurers are responsible for covering the majority of Medicaid enrollees. The ten largest MCOs accounted for 54% of the total Medicaid managed care enrollee market share, with Centene in the top spot with over 10% of the Medicaid managed care market share itself and coverage in 22 states across the U.S.

This OPEN MINDS Market Intelligence Report addresses a number of topics related to understanding the Medicaid managed care market, including:

• An overview of the Medicaid landscape, including total Medicaid enrollment over time and managed care enrollment over time
• The 18 largest MCOs with over 500,000 Medicaid members, and their geographic operating areas
• Trends among the top 10 largest Medicaid MCOs in 2016 and 2017
• A listing of acquisitions, re-procurements, and contracting changes that will effect insurer enrollment

In coming years, we can expect to see additional changes in the Medicaid health plan landscape. There are both pending changes from the Centers for Medicare & Medicaid Services (CMS) that affect all states and individual changes happening in state Medicaid programs. State Medicaid managed care re-procurement will change the number of health plans and the insurers that are dominant in each market, and there is continuing consolidation among U.S. health plans.