Examining the Five Biggest Players in Medicaid Managed Care

July 7, 2023

With over 70% of Medicaid beneficiaries being enrolled in plans from managed care organizations (MCOs), managed care has become a major player in the American health insurance industry. A new article by the Kaiser Family Foundation (KFF) takes a look at five of the largest MCOs and how they are influencing the managed care landscape.

According to Elizabeth Hinton and Jada Raphael, “Five for-profit, publicly traded companies – Centene, Elevance (formerly Anthem), UnitedHealth Group, Molina, and CVS Health – account for 50% of Medicaid MCO enrollment nationally. All five are ranked in the Fortune 500, and four are ranked in the top 100, with total revenues that ranged from $32 billion (Molina) to $324 billion (UnitedHealth Group) for 2022. Each company operates Medicaid MCOs in 12 or more states. All five firms also operate in the commercial and Medicare markets; however, the distribution of membership across markets varies across firms. Two firms – Molina and Centene– have historically focused predominantly on the Medicaid market. Medicaid members accounted for over 90% of Molina’s overall medical membership and nearly 70% of Centene’s medical membership as of March 2023.”

To read more, click here.

(Source: KFF, July 6th, 2023)

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