Health Enrollment Trends for Third Quarter 2016

MCMURRAY, Pa.--()--In the latest Healthcare Business Strategy report, Mark Farrah Associates (MFA),, compared segment membership between 3rd quarter 2015 and 3rd quarter 2016 to provide insights about enrollment trends. MFA’s analysis of data from the NAIC (National Association of Insurance Commissioners), the CA DMHC (California Department of Managed Health Care) and MFA’s ASO estimates indicated the Medicare Advantage and managed Medicaid segments, as well as ASO (administrative services only) business, continued to experience membership increases between September 30, 2015 and September 30, 2016. Enrollment in the Individual, Non-group and Employer Group Risk segments has been consistently declining over the past year.

Based on membership data filed with statutory financial reports, insurance companies provided medical coverage for approximately 266 million people, as of September 30, 2016. Once again, the Employer Group ASO and the Group Risk segments dominated in terms of total membership covering 45% and 22% of the market, respectively. However, growth was most significant in the Managed Medicaid segment as membership increased by 4 million beneficiaries between 3Q15 and 3Q16. The following are key findings from Mark Farrah Associates' assessment of year-over-year third quarter enrollment trends.

  • More than 19.1 million people are currently enrolled in Individual, Non-group medical plans, representing a 1% decrease between 3Q15 and 3Q16.
  • Managed Care Organizations (MCOs) now provide coverage for over 50 million beneficiaries, representing 9% growth, year-over-year. According to CMS reports, a total of over 74.3 million people rely on Medicaid as their source of health insurance coverage as of December 2016.
  • Third quarter membership in Medicare Advantage (MA) plans increased to 18.4 million as of September 30, 2016, from 17.6 million in the prior year.
  • Employer Group Risk membership declined by 245,000 members from approximately 59.7 million to 59.5 million.
  • According to MFA’s recent estimates, Employer Group ASO membership grew by approximately 2.7 million members to 119 million ASO covered lives by company.

As the industry braces for more market changes, notable shifts in enrollment trends will likely continue. The potential of repeal and replacement of the Affordable Care Act, the possibility of restructuring Medicare and Medicaid to reduce federal spending and rising health care costs are at the forefront of policy discussions. MFA will continue to monitor and report on the latest industry developments as the need for health plan market share and financial performance data has never been greater.

To read the full text of "Third Quarter 2016 Health Insurance Enrollment Trends", visit the Analysis Briefs library on Mark Farrah Associates' website.

About Mark Farrah Associates (MFA)

MFA is a leading data aggregator and publisher providing health plan market data and analysis tools for the healthcare industry. Committed to simplifying analysis of health insurance business, our products include Medicare Business Online™, Medicare Benefits Analyzer™, Health Coverage Portal™, County Health Coverage™, and Health Plans USA™.


Mark Farrah Associates
Ann Marie Wolfe, 412-944-2417

Release Summary

Mark Farrah Associates analyzed the latest year-over-year enrollment trends, comparing 3rd quarter 2015 with 3rd quarter 2016 segment membership.


Mark Farrah Associates
Ann Marie Wolfe, 412-944-2417