The report examined 381 metropolitan statistical areas, the 50 states and the District of Columbia and tabulated market shares for the two largest health insurance companies, according to a Dec. 12 release sent to Becker’s.
Here are five things to know about the Medicare Advantage market, per the AMA:
1. At the national level, the 10 largest Medicare Advantage providers by market share were:
1. UnitedHealth Group (28%)
2. Humana (18%)
3. CVS (Aetna) (11%)
4. Kaiser Permanente (6%)
5. Elevance Health (6%)
6. Centene Corp. (5%)
7. Cigna (2%)
8. Blue Cross Blue Shield of Michigan (2%)
9. Highmark (1%)
10. SCAN (1%)
2. In 31% of metropolitan statistical areas, one health insurer held a market share of at least 50%.
3. UnitedHealth Group was the largest health insurer by market share in 42% of metropolitan statistical areas, followed by Humana with a market share lead in 22% of metropolitan statistical areas and CVS (Aetna) with a market share lead in 7% of metropolitan statistical areas.
4. Under current federal guidelines that define the regulatory threshold for markets to be considered highly concentrated, 71% of metropolitan statistical area-level markets were highly concentrated in 2022, down from 87% in 2017.
5. Under proposed federal guidelines supported by the AMA, 97% of metropolitan statistical area-level markets would be highly concentrated. A lower threshold for what constitutes a highly concentrated market may increase scrutiny of health insurance mergers and limit harmful consolidation, the release said.
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