Author Archives: Carl Mercurio

Medicaid Plan Profit Margin Rises to 2.8% In 2020

An analysis by HMA Information Services, a division of Health Management Associates, shows that Medicaid managed care plans in 34 states and Washington, DC, posted a net underwriting margin of 2.8 percent in 2020, compared to less than 0.1% in 2019. The data include financial information for 232 Medicaid managed care plans, with total membership of 51 million in 2021. Not included are Medicaid plans in California and Arizona, which don’t report comparable financial information.

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FL Quarterly Statewide Medicaid Managed Care Reports, 2014 – Autumn 2020

1. Quarterly Statewide Medicaid Managed Care Dental Services Report, Autumn 2020
2. Quarterly Statewide Medicaid Managed Care Report, Winter 2019
3. Quarterly Statewide Medicaid Managed Care Report, Winter 2018
4. Quarterly Statewide Medicaid Managed Care Report, Spring 2017
5. Quarterly Statewide Medicaid Managed Care Report, Winter 2016
6. Quarterly Statewide Medicaid Managed Care Report, Spring 2016
7. Quarterly Statewide Medicaid Managed Care Report, Winter 2015
8. Quarterly Statewide Medicaid Managed Care Report, Fall 2015
9. Quarterly Statewide Medicaid Managed Care Report, Summer 2015
10. Quarterly Statewide Medicaid Managed Care Report, Winter 2014

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Managed Long-Term Services, Supports Programs RFP Calendar

Current contract term dates and RFP timing details for Managed Long-Term Services and Support programs and carve-ins in 22 states are presented in the data package below.

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New On HMAIS: Medicare Advantage Enrollment Tool

HMA Information Services announced on May 30, 2019, the launch of a Medicare Advantage enrollment tool allowing users to search for Medicare Advantage enrollment data by state and among top plans for the period indicated and for the corresponding prior-year period. Data includes market share as well as minimum and maximum Star Ratings, premiums, and deductibles by plan. The tool is located here and is available to all current subscribers to HMAIS. Currently, the tool presents data as of February 2019 and will be updated monthly.

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Medicaid Plan Profit Margin Dips to 0.5% In 2018

An analysis by HMA Information Services, a division of Health Management Associates, shows that Medicaid managed care plans in 34 states and Washington, DC, posted a net underwriting margin of 0.5 percent in 2018, down 10 basis points from 0.6 percent in 2017. For-profit plans posted a net underwriting margin of 1.3 percent in 2018, while not-for-profit plans posted a net underwriting loss of 0.9 percent. Overall, margins have fallen consistently since hitting a four-year high of 2.4% in 2015. The data include financial information for about 210 Medicaid managed care plans, with total membership of 38 million in 2018. Not included are Medicaid plans in California and Arizona, which don’t report financial information through NAIC.

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MI Medicaid Managed Care Rates by Eligibility Category, 2017-18

The following spreadsheet contains an analysis of Michigan Medicaid managed care plan rates by eligibility category. Per member per month rates in Michigan were $171 in 2018 for traditional Medicaid (aka Temporary Assistance for Needy Families (TANF) and Children’s Health Insurance Program (CHIP) populations), down 0.3% compared to 2017. Expansion PMPM was $365, up 0.7%.

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LA Medicaid Managed Care Rates by Eligibility Category, 2017-18

The following spreadsheet contains an analysis of Louisiana Medicaid managed care plan rates by eligibility category. Per member per month rates in Louisiana were $287 in 2018 for traditional Medicaid (aka Temporary Assistance for Needy Families (TANF) and Children’s Health Insurance Program (CHIP) populations), up 0.8% compared to 2017.

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IN Medicaid Managed Care Rates by Eligibility Category, 2017-18

The following spreadsheet contains an analysis of Indiana Medicaid managed care plan rates by eligibility category. Per member per month rates in Indiana were $213 in 2018 for traditional Medicaid (aka Temporary Assistance for Needy Families (TANF) and Children’s Health Insurance Program (CHIP) populations), up 1.7% compared to 2017. Expansion PMPM was $520, up 15.1%.

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IA Medicaid Managed Care Rates by Eligibility Category, 2017-18

The following spreadsheet contains an analysis of Iowa Medicaid managed care plan rates by eligibility category. Per member per month rates in Iowa were $238 in 2018 for traditional Medicaid (aka Temporary Assistance for Needy Families (TANF) and Children’s Health Insurance Program (CHIP) populations), up 2.4% compared to 2017. Expansion PMPM was $472, down 3%.

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FL Medicaid Managed Care Rates by Eligibility Category, 2017-18

The following spreadsheet contains an analysis of Florida Medicaid managed care plan rates by eligibility category. Per member per month rates in Florida were $207 in 2018 for traditional Medicaid (aka Temporary Assistance for Needy Families (TANF) and Children’s Health Insurance Program (CHIP) populations), up 0.8% compared to 2017.

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