Medicare Advantage plans are expected to make up half of all Medicare enrollment by 2026, with the national average currently at 45.5 percent. Some states, however, are lagging behind the rest of the country.
Becker's spoke with three payers in some of the states with the lowest enrollments to see what direction they are going with Medicare Advantage plans.
Wyoming
Wyoming has 116,902 individuals enrolled in Medicare and nine MA plans available in the state, which is up from six in 2021. Currently, 6.1 percent of the state's Medicare population is enrolled in an MA plan, the lowest enrollment in the nation.
The state's largest payer, Blue Cross Blue Shield of Wyoming, does not offer a Medicare Advantage plan, only Part D coverage.
"As a state, Wyoming has not traditionally embraced managed care in Medicare or Medicaid. However, Medicare Advantage PPO products are starting to gain traction in Wyoming," a BCBSWY spokesperson told Becker's. "Blue Cross Blue Shield of Wyoming continues to monitor and evaluate product offerings that will improve choice and quality of care to Wyoming residents."
North Dakota
North Dakota has 136,679 individuals enrolled in Medicare and 23 MA plans available in the state, which is up from 19 in 2021. Currently, 8.5 percent of the state's Medicare population is enrolled in an MA plan.
The state's largest payer, Blue Cross Blue Shield of North Dakota, first began offering Medicare Advantage plans in 2021 through a partnership with a BCBS Michigan subsidiary.
BCBSND CEO Dan Conrad told Becker's the state has been slow to adopt MA plans but the company now offers two. It started with five counties and has since expanded to 40 across the state.
"We've seen quite a bit of growth year over year and we're seeing a really warm reception from the marketplace," Mr. Conrad said. "We had to broaden our offerings to remain competitive in that space because it's a very attractive product for our seniors. I think penetration rates are going to grow closer to national levels in North Dakota now that there's a wider variety of offerings."
Maryland
Maryland has 1,070,242 individuals enrolled in Medicare and 49 MA plans available in the state, which is up from 41 in 2021. Currently, 18.3 percent of the state's Medicare population is enrolled in an MA plan.
The state has noticeably fallen behind other states in the region in regard to MA enrollment, and the state commissioned a report in 2020 to study how the situation developed.
"Given the relationship of Medicare Advantage enrollment with the availability of 4+ star rated plans, staff believes that low Medicare Advantage enrollment in Maryland is primarily driven by the relatively low quality plans in Maryland," the report said.
The report found that only 33 percent of MA plans in the state received at least four CMS stars within five years of launch, and it takes 10 years on average for new plans to earn four stars.
"Thus, current Medicare Advantage penetration is driven by the decision of Medicare Advantage plans to enter the market 5-15 years ago and their willingness to persist in the market with low enrollment for a prolonged period of time," the report said.
Montana
Montana has 243,242 individuals enrolled in Medicare and 27 MA plans available in the state, which is up from 19 in 2021. Currently, 24.4 percent of the state's Medicare population is enrolled in an MA plan.
The state's largest payer is Blue Cross and Blue Shield of Montana, which is owned by Health Care Service Corp. The company said Aug. 1 it is expanding MA offerings to an additional 1.1 million Medicare-eligible individuals in 150 counties across Montana, Illinois, New Mexico, Oklahoma and Texas.
"We had our largest ever expansion in 2022, and that included Montana. We're again having our largest expansion in 2023," HCSC Medicare President Christine Kourouklis told Becker's. "When I think about Montana, it really represents a tremendous opportunity for us to go deeper and close gaps in coverage, especially in rural and underserved areas."