Using MSIS Data to Analyze Medicaid Eligibility and Managed Care Enrollment Patterns in 1999. TABLES 3A-3B: Medicaid Managed Care Enrollment by Plan Type and Month in 1999

02/01/2003

Tables 3A shows the number of Medicaid beneficiaries enrolled in any of the eight types of managed care plans during each month of 1999. The last column presents a monthly average for 1999. The state-specific footnotes describe the type of plan included in the "other" category. Persons could be counted in Table 3A more than once during a month if they were enrolled in more than one managed care plan. As a result, the table presents a "duplicated" count of enrollees. (An unduplicated count follows in Table 4.) Table 3B converts the data in Table 3A to a percent distribution by month; the percentages reflect the duplicated count in Table 3A.

Much of this information has not been available in the past. The number of persons enrolled in different types of Medicaid managed care each month was not reported in 2082 data. The only nationwide data on enrollment in Medicaid managed care from CMS has been the number of persons in different types of Medicaid managed care in June of each year (nationwide and at the state level). Since managed care enrollment levels can fluctuate during the year, this more comprehensive information in Table 3A is a useful addition. The MSIS data also provide enrollment for several types of managed care not explicitly reported in the other CMS data, including BHPs, dental plans, prenatal/delivery plans, LTC plans, and PACE plans.

Findings

  • On average during 1999, 11.6 million Medicaid eligibles, or just over one-third of the Medicaid beneficiaries, were enrolled in HMOs. Close to 5 million individuals were enrolled in dental managed care plans under Medicaid; 3.6 million were enrolled in PCCMs; and 3.3 million were enrolled in BHPs. Enrollment in three types of plan -- prenatal/delivery, long-term care and PACE -- was considerably smaller, with a combined total of 44,000 a month nationwide. Finally, almost 900,000 Medicaid beneficiaries were enrolled on average in "other" managed care plans during 1999.

  • During 1999, the number of Medicaid enrollees in each of the eight types of managed care increased each month. HMO enrollment increased by just over 2 percent from January to December. BHP enrollment grew by 10 percent, PCCM enrollment grew 8 percent, and dental plan enrollment increased by less than 1 percent. Enrollment in the prenatal/delivery plans and "other" plans increased at even greater rates, but these plans continued to be relatively small nationwide relative to the other types of plans.

  • Although not explicitly reported in Table 3A, all but 3 states (Alaska, Louisiana, and Wyoming) reported some enrollment in at least one type of Medicaid managed care during the year. The number of states reporting enrollment in each type of managed care was as follows: HMO -- 45 states; dental -- 3 states; BHP -- 13 states; prenatal/delivery -- 1 state; LTC -- 1 state; PACE -- 6 states; PCCMs -- 28 states; and "other" -- 9 states.

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