New Report Shows Big Jump in Medicaid Managed Care Penetration, Consolidation Trends

Staff Report From Georgia CEO

Monday, November 30th, 2015

The report, "The Still Expanding State of Medicaid in the United States" presented by PwC's Strategy& at Medicaid Health Plans of America's annual conference, gives a view of the Medicaid market, its growth potential, and assesses the continuing effect of Medicaid expansion.

Noteworthy results in the data: unprecedented growth in Medicaid with 1 in 20 Americans added to Medicaid in the past two years and a large increase in Medicaid managed care penetration. "In 2014, 65% of Medicaid beneficiaries were in a private Medicaid health plan," noted Ari Gottlieb, director at PwC Strategy& and author of the report. "In 2015, that percent is now over 70%, with that growth rate outpacing overall program growth."

Another big trend noted in the report is consolidation in the Medicaid managed care industry: of the 194 private Medicaid plans serving Medicaid beneficiaries in 2015, the largest 12 plans collectively have 56% of that total membership. 

"This consolidation is significant because the resources of these big plans will positively affect beneficiaries' care," said Jeff Myers, president and CEO of Medicaid Health Plans of America. "These largest plans can draw on big data and analytics to tweak and customize the care of their Medicaid populations that will affect their health and overall quality of life in ways not seen before."