Medicaid Managed Care: Substantial Shifts In Market Landscape And Acquisitions, 2006-20

Area of Science:

• Health Services Research
• Health Economics
• Market Analysis

Background:

• The Medicaid managed care market has undergone substantial changes over the past two decades.
• Market concentration has increased, with five national firms managing nearly half of all enrolled beneficiaries.

Purpose of the Study:

• To analyze the composition and evolution of the Medicaid managed care market between 2006 and 2020.
• To investigate the impact of acquisitions on market structure and payer dominance.

Main Methods:

• Utilized Medicaid managed care enrollment data from 2006-2020.
• Employed a novel dataset detailing acquisitions within the managed care market.

Main Results:

• Observed a significant decrease in the number of unique parent payers, despite overall enrollment growth.
• Found a high volume of acquisitions, with approximately 25% of plans involved.
• Documented the increasing dominance of national payers and the declining presence of local payers.

Conclusions:

• The Medicaid managed care market is characterized by increasing consolidation and national payer influence.
• Further research is necessary to assess the implications for market competition, state finances, and beneficiary health outcomes.