Jump to navigation. Medicare managed care enrollment has fluctuated over the years and is a frequently requested statistic. Often researchers are interested in penetration rates or the percentage of Medicare beneficiaries enrolled in a Medicare managed care plan. The CMS website has two sections that provide Medicare managed care enrollment information that can be used to calculate penetration rates depending on the year s of interest.
Chapter 1. An Overview of Medicaid Managed Care
Managed Care Fact Sheets > National Managed Care Penetration | MCOL
The rapid growth of Medicare managed care over the past decade has the potential to increase the efficiency of health-care delivery. Improvements in care management for some may improve efficiency system-wide, with implications for optimal payment policy in public insurance programs. These system-level effects may depend on local health-care market structure and vary based on patient characteristics. We use exogenous variation in the Medicare payment schedule to isolate the effects of market-level managed care enrollment on the quantity and quality of care delivered.
Public Use Sources for Managed Care Enrollment and Penetration Rates
Although not all state Medicaid programs contract with MCOs, a large and growing majority do, and states are also rapidly expanding their use of MCOs to reach larger geographic areas, serve more medically complex beneficiaries, deliver long-term services and supports, and, in states that have expanded Medicaid under the Affordable Care Act ACA , to serve millions of newly eligible low-income adults. To shed light on broader market dynamics, the Tracker also provides data on parent firm participation in other health insurance market sectors. The Medicaid MCO enrollment data included in this Tracker were obtained from managed care enrollment reports posted on state Medicaid websites or, in some cases, provided to us by state Medicaid officials. Not all states with Medicaid MCOs currently post this information; as additional states make their MCO enrollment data available, we will add these data to the Tracker. This Data Collection, the Medicaid Managed Care Market Tracker, provides information related to risk-based Medicaid managed care organizations MCOs that provide comprehensive services, including acute care services and, in some cases, long-term services and supports as well, to Medicaid enrollees.
Medicare Advantage plans have played an increasingly larger role in the Medicare program as the share of Medicare beneficiaries enrolled in Medicare Advantage has steadily climbed over the past decade. The trend in enrollment growth is continuing in , and has occurred despite reductions in payments to plans enacted by the Affordable Care Act of ACA. This Data Spotlight reviews national and state-level Medicare Advantage enrollment trends as of March and examines variations in enrollment by plan type and firm. It analyzes the most recent data on premiums, out-of-pocket limits, and quality ratings.