Here is what you’ll find in this week’s newsletter!

1. Important links 🔗 - the best articles we found this week about the Medicare Market along with links to Jared’s recent LinkedIn posts.

2. Deep Dive 📚 - Medicare Advantage Companies – the Few and the Many

3. Sponsor Snapshot 🚀 - brought to you by Modivcare

4. Compliance Chatter 📢 - Tips to keep you compliant for Medicare AEP 2025.

5. Data Visual of the Week - 1/3rd of beneficiaries can choose among Medicare Advantage plans offered by 10 or more firms in 2024

It’s only a 5 minute read, but it will make you 10x smarter.

DEEP DIVE 📚

Medicare Advantage Companies - the Few and the Many

Everyone loves a good underdog story.  We cheer for Rudy to make the team; we win the case with Elle Woods; we journey with Sam and Frodo.  When the long shot wins, we’re inspired and hopeful.

Now you may be thinking, what does any of this have to do with the Medicare market?

The Few –

The Medicare Advantage market is dominated by the big guys.   In 2024, nearly half of MA enrollees are covered by UnitedHealthcare or Humana.  Once we add in the Blues, CVS, Cigna, Centene, and Kaiser Permanente, you have the “who’s who” of Medicare Advantage.

But if Hollywood has taught us anything, it’s that we should pay attention to the underdogs too. 

The Many –

As we see in the KFF data table above, 16% of the MA market belongs to the “other” companies.

The “other” companies are upwards of 200 different firms.  In total, this segment of the market added over 240,000 enrollees from March 2023 to March 2024.  This growth rate, around 5%, closely matched UnitedHealthcare’s growth rate over the same time period and exceeded the growth rate of Kaiser Permanente, Cigna, and Centene.

Today’s deep dive looks at 3 “other” companies forging their own way into the Medicare Advantage market:

1. Alignment Health       66% growth rate from 2023 to 2024

2. Devoted Health          75% growth rate from 2023 to 2024

3. Zing Health                199% growth rate from 2023 to 2024 

The map below, generated using the MMI plus web app, illustrates the current enrollment footprint for these 3 companies.

Alignment Health

Fast facts:

• Founded in 2013

• Based in Orange, CA

• Traded on NASDAQ: ALHC

• 3.95 average star rating from CMS

Alignment Health nearly doubled its enrollee count from Jan 2021 to Jan 2024, despite a small dip in total enrollees from 2022 to 2023. 

Alignment’s growth over those years was supported by the introduction of new states in 2022 (AZ) and 2023 (FL, TX).  CA remains their largest state by far, comprising over 90% of their members.  TX is showing strong early growth trends for Alignment.

Alignment Health’s footprint and enrollee count by state as of September 2024:

A comparison of the current plan types offered by Alignment Health shows a distribution similar to the nationwide MA market, with around 20% of enrollees in SNP plans.

2025 - 2027 Growth Plan:

• Increase penetration in existing states before expanding to new states

• Increase market share in CA from 5% to 20%, targeting 0.5 – 1.0 million enrollees

• Use CA as a prototype, develop best practices to use for later expansions

  → Alignment Health 1 Million Enrollees

Alignment Health announced their Q2 2024 results in early August, highlighting increased revenue and strong MA membership growth year-over-year.

→ Alignment Healthcare Q2 2024 Results

Devoted Health

Fast facts:

• Founded in 2017

• Based in Waltham, MA

• 4.6 average star rating from CMS

Devoted Health has delivered strong growth since 2021 – doubling their enrollees from 2021 to 2022. 

2023 growth was fueled by the introduction of 8 new states and that growth trend remained strong into 2024.  OH, TX, and FL are their largest states, totaling around 2/3 of their members. AL has their highest growth rate from 2023 into 2024.

Devoted Health’s footprint and enrollee count by state as of September 2024:

A comparison of the current plan types offered by Devoted Health shows a distribution similar to the nationwide MA market, with around 20% of enrollees in SNP plans.

2025 Growth Plan:

• Expanding into a significant number of new counties across their existing states

• Adding 7 new states – Arkansas, Georgia, Indiana, Kentucky, Mississippi, Missouri, and Washington

Devoted Health recently announced another completed round of series E funding to support continued growth headed into 2025 and beyond.

→ Devoted Health Funding Round

Zing Health

Fast facts:

• Founded in 2019

• Based in Chicago, IL

• Focus on providing healthcare to underserved communities

While they have a smaller member count than Alignment or Devoted, Zing Health has shown solid growth rates since 2021.   Growth from 2023 to 2024 was driven by enrollee increases in IL and MI.  For 2024 year-to-date, IN is their growth rate leader.

Zing Health’s footprint and enrollee count by state as of September 2024:

A comparison of the current plan types offered by Zing Health shows a distinct difference from the nationwide MA market, with a much greater proportion of Zing’s enrollees in SNP plans.

2025 Growth Plan:

• Adding several new counties within their existing states

• Expanding into 3 new states – Mississippi, Ohio, and Tennessee

Zing was impacted by the CMS star rating miscalculations this past year.  However, their member growth over recent years has been strong and should continue given their expansion into new states.

→ Zing Health 2024 Star Ratings

→ Zing Health Raises 140 Million to Expand Access to Its Integrated Chronic Special Needs Focused Medicare Advantage Plans

What To Watch For

As we head into AEP season, headlines are likely to be dominated by the large players in the MA market. 

But we’ll also keep you updated on the “others”.    

Call them underdogs, up-and-comers, disruptors, little guys, longshots, sleepers, or small fries.  Just don’t forget there are more players making moves in the market than only the big dogs!

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MA enrollment data was pulled using our Medicare Advantage Enrollment Insights Web App. available to MMI+ subscribers. Get access now!

DATA VISUAL OF THE WEEK

This week’s data visual comes from KFF and analyzes CMS Landscape files for 2024 and June 2023 Medicare Enrollment Dashboard data.

If you’re ready, here are some ways we can help you:

• Newsletter Sponsorship opportunities: Promote your product or services to leaders in the Medicare space. Let’s discuss. (link)

• Market Research: Reports that help you wrap your arms around the Senior focused insurance markets. (link)

• Consulting: We can help you develop new insurance products for the Medicare market, appraise your books of business, and keep you compliant. Let’s discuss. (link)