CMS data: Medicare Advantage enrollment now more than 31M

Enrollment in Medicare Advantage (MA) is nearing 31.2 million following the annual enrollment period, about half of the total Medicare population, according to recent data from the Biden administration.

The Centers for Medicare & Medicaid Services (CMS) released its latest look at enrollment in the MA program, which showed that nearly 30.9 million people had enrolled in MA plans, with most choosing plans that have prescription drug coverage. In addition, 308,881 people are enrolled in commercial Medicare-Medicaid plans, according to the data.

By comparison, about 29.1 million people had such coverage in February 2022, for a year-over-year increase of 7.1%. The 2023 data represent 776 MA contracts, up from 740 a year ago.

Enrollment in standalone prescription drug plans was 22.5 million, bringing total enrollment in private Medicare coverage to 54 million.

The data come as the program faces questions from legislators and regulators about payment while insurers are prioritizing growth. Over the past week, the industry and officials at CMS and the Department of Health and Human Services have sparred over the proposed 2024 payment rates, which payers argue represent a cut to the program.

The Biden administration also recently finalized a rule governing risk adjustment data validation (RADV) audits in the program, which could leave insurers on the hook for billions in overcharges they'll need to repay. These companies are weighing the next steps to push back on the RADV changes.

Stat further analyzed the CMS data and found that the industry leaders—UnitedHealthcare and Humana—came out on top in enrollment growth. UnitedHealth added 945,000 new members to bring its total MA enrollment to 8.9 million, and Humana's enrollment grew to 5.9 million after it bounced back from a poor showing in the 2022 annual enrollment period that spooked investors.

That means UHC and Humana scooped up two-thirds of new MA enrollees for 2023, according to the Stat analysis. Two-thirds of all MA members are enrolled in plans from one of five insurers: UHC, Humana, Aetna, Elevance Health or Kaiser Permanente.

Stat's report also found that insurtechs like Clover Health and Alignment Healthcare remain relatively small MA players but are gaining ground.