1
Section 7: Health Plans
• Health plan market shares
• Fully-insured market in total
• Small group and individual market
• HMO financial statistics
• Net income & margins
• Reserves
• Health Plan Medical Loss Ratios
• HMO enrollment statistics
HEALTH PLAN MARKET SHARES
3
Health Plan Market Shares:
Total Fully-Insured Private Market, 2013*
(Premium Volume: $6.2 billion)
35%
31.2%
30%
27.6%
26.7%
25%
20%
15%
10%
5.5%
5%
3.6%
1.7%
0.8%
0.8%
0.7%
0.7%
0.6%
Federated
Mutual Ins.
Co.
Health Care
Services
Corp.
Cigna
0%
Blue Cross HealthPartners
Blue Shield of
MN
Medica
PreferredOne
United
Healthcare
Genworth Life Time Ins. Co.
(Assurant
Health)
Companies with common ownership were treated as one entity. For example, Blue Cross Blue Shield of
Minnesota includes BCBSM and Blue Plus. Fully insured market only, market share based on premium volume.
Source: MDH Health Economics Program, analysis of MCHA Premium Database for 2013.
*Contains preliminary unaudited and incomplete data
Other (149
Companies)
4
Market Share of Minnesota Non-Profit Health Plans
2005 to 2013
100%
90%
80%
69.9%
70%
65.2%
64.8%
62.1%
60%
59.5%
56.5%
52.1%
50%
50.0%
49.5%
2012
2013
40%
30%
20%
10%
0%
2005
2006
2007
2008
2009
2010
Market share calculated as share of premiums in the fully-insured health insurance market.
Source: MDH analysis of the premium assessment base for the Minnesota Comprehensive Health Association.
Contains preliminary data
2011
5
Health Plan Market Shares: Small Group
Market, 2013
Total Premium Volume in 2013: $1.35 Billion
50%
40.3%
40%
29.5%
30%
22.1%
20%
10%
5.6%
2.4%
0.1%
0%
Blue Cross Blue Shield of
MN
Healthpartners
Medica
PreferredOne
Federated Mut Ins Co
Companies with common ownership were treated as one entity. For example, Blue Cross Blue Shield of MN includes Blue Cross Blue
Shield of Minnesota and Blue Plus. Market shares based on premium volume; fully insured market only.
Source: Minnesota Department of Commerce, "Report of 2013 Loss Ratio Experience in the Individual and Small Employer Health Plan
Markets for: Insurance Companies Nonprofit Health Service Plan Corporations and Health Maintenance Organizations," June 2014.
Assurant
6
Health Plan Market Shares: Individual
Market, 2013
Total Premium Volume in 2013: $710 Million
80%
64.5%
60%
40%
20%
15.8%
9.8%
6.0%
2.8%
0.8%
0.2%
0.0%
American
Family Mut Ins
Co
Golden Rule
Ins Co
American
Republic Ins
Co
0%
Blue Cross
Blue Shield of
MN
Medica
HealthPartners
Assurant
PreferredOne
Note: Companies with common ownership were treated as one entity. Market shares based on premium volume; fully
insured market only.
Source: Minnesota Department of Commerce, "Report of 2013 Loss Ratio Experience in the Individual and Small Employer
Health Plan Markets for: Insurance Companies, Nonprofit Health Service Plan Corporations, and Health Maintenance
Organizations ," June 2014.
HMO FINANCIAL STATISTICS
8
Summary of HMO Financial Trends,
2008 to 2013
In Millions of Dollars
2008
Net Income
2009
2010
2011
2012
2013
$26.0
$175.5
$250.6
$233.7
$250.3
$226.0
Total Revenue
$5,786.3
$6,582.9
$6,954.5
$6,971.7
$7,326.8
$7,746.9
Operating Income as % of
Revenue
0.5%
1.9%
2.6%
2.3%
2.4%
2.2%
Net Income as % of Revenue
0.4%
2.7%
3.6%
3.4%
3.4%
2.9%
Minnesota products only.
Source: MDH Health Economics Program analysis of HMO annual reports.
9
Net Income and Profitability by HMO, 2013
Net Income
(millions)
Total Revenue
(millions)
Net Income as %
of Revenue
Blue Plus
$73.2
$1,016.7
7.2%
Group Health
$43.0
$1,040.2
4.1%
HealthPartners
$65.6
$1,279.2
5.1%
Gundersen
$0.0
$2.2
(1.4%)
($3.8)
$1,778.4
(0.2%)
Metropolitan
$4.0
$154.5
2.6%
PreferredOne
($2.7)
$59.6
(4.5%)
Sanford
($0.4)
$3.0
(13.0%)
UCare
$47.2
$2,413.2
2.0%
All HMOs
$226.0
$7,746.9
2.9%
Medica
Minnesota products only.
Source: MDH Health Economics Program analysis of HMO annual reports.
10
Minnesota HMO Net Income by Product Line,
2008 to 2013
In Millions of Dollars
$300
$250
$200
$150
$100
$50
$0
-$50
Commercial
PMAP,
PGAMC,
MNCare
Medicare
MSHO,
MDHO, and
SNBC
All Other
Total
2008
$7.0
$18.7
($0.1)
$13.9
($13.4)
$26.0
2009
$35.2
$108.1
$18.6
$26.5
($13.0)
$175.5
2010
$73.9
$125.1
$1.8
$43.7
$6.0
$250.6
2011
$102.6
$39.1
$37.9
$46.3
$7.8
$233.7
2012
$78.3
$16.6
$53.9
$50.6
$51.0
$250.3
2013
$13.8
$96.1
$58.3
$48.9
$8.9
$226.0
PMAP is Prepaid Medical Assistance Program; PGAMC is Prepaid General Assistance Medical Care; MSHO is
Minnesota Senior Health Options; All Other includes: Medicare Supplemental, Dental and Minnesota Disability
Health Options.
Source: MDH Health Economics Program analysis of HMO annual reports.
11
Minnesota HMO Net Income per Member
Month by Product Line, 2008 to 2013
$120
$100
$80
$60
$40
$20
$0
-$20
Commercial
PMAP, GAMC,
MNCare
Medicare
MNSHO and
MNDHO
Minnesota
Products Total
2008
$1.52
$4.13
($0.12)
$33.97
$2.46
2009
$8.47
$21.95
$15.79
$60.26
$16.30
2010
$20.35
$23.48
$1.35
$65.09
$22.75
2011
$36.03
$6.67
$25.70
$101.76
$21.84
2012
$34.35
$2.87
$34.90
$67.42
$23.75
2013
$6.91
$15.89
$33.14
$55.08
$21.00
PMAP is Prepaid Medical Assistance Program; PGAMC is Prepaid General Assistance Medical Care; MSHO is
Minnesota Senior Health Options; and MDHO is Minnesota Disability Health Options.
Source: MDH Health Economics Program analysis of HMO annual reports.
12
Minnesota HMO Net Income by Product Line,
2013
In Millions of Dollars
$250
$226.0
$200
$150
$100
$64.30
$58.30
$48.90
$50
$31.70
$13.80
$8.90
$0
Prepaid
Medical
Assistance
Program
(PMAP)
Medicare
MSHO,
MDHO, and
SNBC
MNCare
Commercial
Other
PMAP is Prepaid Medical Assistance Program; MSHO is Minnesota Senior Health Options; MDHO is Minnesota
Disability Health Options; SNBC is Special Needs Basic Care; All Other includes: Medicare Supplemental, and
Dental.
Source: MDH Health Economics Program analysis of HMO annual reports.
Total
Minnesota
Products
13
Minnesota HMO Net Income per Member
Month by Product Line, 2013
$140
$132.97
$120
$100
$80
$60
$55.08
$40
$33.14
$21.67
$20
$21.00
$14.04
$6.91
$0
Other
MSHO,
MDHO, and
SNBC
Medicare
MNCare
Prepaid
Medical
Assistance
Program
(PMAP)
Commercial
PMAP is Prepaid Medical Assistance Program; MSHO is Minnesota Senior Health Options; MDHO is Minnesota
Disability Health Options; SNBC is Special Needs Basic Care; All Other includes: Medicare Supplemental, and
Dental.
Source: MDH Health Economics Program analysis of HMO annual reports.
Total
Minnesota
Products
14
Minnesota HMO Profitability by Product Line,
2008 to 2013
Net Income as % of Revenue
20%
15%
10%
5%
0%
-5%
-10%
-15%
2008
2009
2010
2011
2012
2013
Commercial
PMAP,
PGAMC,
MNCare
0.3%
1.6%
3.2%
5.1%
4.1%
0.7%
1.0%
4.8%
5.3%
1.5%
0.7%
3.5%
Medicare
MSHO,
MDHO, and
SNBC
All Other
Total
0.0%
2.1%
0.2%
3.4%
4.4%
4.3%
1.4%
2.4%
3.9%
4.1%
3.6%
3.1%
(12.7%)
(11.6%)
2.5%
4.7%
16.9%
4.9%
0.4%
2.7%
3.6%
3.4%
3.4%
2.9%
PMAP is Prepaid Medical Assistance Program; MSHO is Minnesota Senior Health Options; MDHO is Minnesota
Disability Health Options; SNBC is Special Needs Basic Care; All Other includes: Medicare Supplemental, and
Dental.
Source: MDH Health Economics Program analysis of HMO annual reports.
15
Sources of HMO Net Income, 2008 to 2013
In Millions of Dollars
2008
2009
2010
2011
2012
2013
Sources of Net Income:
Net underwriting gain/loss
$31.3
$123.1
$181.4
$161.6
$174.9
$173.0
Investment Income
($5.5)
$52.4
$69.4
$44.5
$39.9
$39.4
Other
$0.2
$0.0
($0.2)
$27.5
$35.5
$13.7
Net Income
$26.0
$175.5
$250.6
$233.7
$250.3
$226.0
(21.2%)
29.8%
27.7%
19.1%
16.0%
17.4%
Investment income as % of net income
Minnesota products only.
Source: MDH Health Economics Program analysis of HMO annual reports.
16
Investment Income as a Percent of Net Income by
HMO, 2013
Investment
Income
(millions)
Blue Plus
Net Income
(millions)
Investment
Income as Pct of
Net Income
$14.8
$73.2
20.2%
Group Health
$3.2
$43.0
7.5%
HealthPartners
$3.6
$65.6
5.5%
Gundersen
$0.0
($0.0)
0.0%
Medica
$11.5
($3.8)
(301.0%)
Metropolitan
($0.3)
$4.0
(7.1%)
$0.2
($2.7)
(6.8%)
($0.0)
($0.4)
0.5%
$6.3
$47.2
13.4%
$39.4
$226.0
17.4%
PreferredOne
Sanford
UCare
All HMOs
Source: MDH Health Economics Program analysis of HMO annual reports.
17
Reserves, Medical Expenses, and Regulatory
Minimum Level by HMO, 2013
Reserves
(millions)
Total
Expenses
(millions)
Reserves as %
of Total
Expenses
Reserves as %
of Regulatory
Level
Blue Plus
$448.9
$924.7
48.5%
1162%
Group Health*
$158.8
$405.5
39.1%
737%
$1.5
$2.0
74.3%
230%
HealthPartners*
$846.4
$1,100.5
76.9%
632%
Medica
$404.5
$1,212.6
33.4%
609%
Metropolitan
$28.3
$131.3
21.5%
504%
PreferredOne
$7.7
$53.7
14.3%
278%
Sanford
$1.3
$3.1
41.0%
395%
$443.2
$2,195.6
20.2%
501%
$2,340.5
$6,560.4
35.7%
653%
Gundersen
UCare
All HMOs
*Fee-for-service revenue earned was subtracted from expenses to approximate member only expenses.
“Regulatory level” is the authorized control level; total expenses is from line 16 of HMO Minnesota
Supplement Report #1.
Minnesota products only.
Source: MDH Health Economics Program analysis of HMO annual reports.
18
Total Minnesota HMO Reserves Relative to
Regulatory Minimum Levels, 2003 to 2013
800%
Reserves as a Percent of Regulatory
Minimum
700%
600%
500%
400%
300%
200%
100%
0%
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
Fee-for-service revenue earned was subtracted from expenses to approximate member only expenses.
“Regulatory minimum level” is the authorized control level.
Source: MDH Health Economics Program analysis of HMO annual reports.
HEALTH PLAN MEDICAL LOSS RATIOS
20
Medical Loss Ratio in the Individual Market, 2013
(Carriers with $2 million or more in Premium Revenue)
Claims Expense
Net
American Family Mutual
Premium1
Incurred Claims
MLR2
Quality
Improvement
Fraud
Total
5,917,850
5,686,970
0
0
445,433,947
410,826,000
2,682,963
52,655
HealthPartners Inc.
15,979,000
17,283,000
145,000
0
17,428,000 114.2%
HealthPartners IC
53,738,000
45,452,000
1,335,000
0
46,787,000
90.8%
John Alden Life IC
2,514,806
1,571,953
15,086
973
1,588,012
70.1%
Medica Health Plans
5,560,982
8,456,183
17,060
0
8,473,243
52.7%
106,802,111
102,155,810
900,156
0
103,055,966
90.5%
PreferredOne IC
19,924,470
14,363,661
376,987
0
14,740,648
78.0%
Time IC
38,664,498
30,125,280
298,233
19,589
30,443,102
80.4%
694,535,664
635,920,857
5,770,485
73,217
641,764,559
90.8%
BCBSM
Medica IC
Total
Source: MDH Health Economics Program analysis of data from National Association of Insurance
Commissioners (NAIC), Supplementary Health Care Exhibit—Part 1; Note 1: premiums exclude taxes and
fees. Note 2: Beginning in 2012, federal law requires insurance companies that don’t include certain small and
new companies to issue rebates to consumers for an MLR under 80% in the individual market for the prior
year.
5,686,970 102.5%
413,561,618
92.8%
21
Medical Loss Ratio in the Small Group Market, 2013
(Carriers with $2 million or more in Premium Revenue)
Claims Expense
Net
BCBSM
Premium1
Incurred
Claims
MLR2
Quality
Improvement
Fraud
Total
529,674,020
476,362,000
3,545,565
51,205
479,958,770
91.3%
Federated Mutual IC
31,932,465
26,461,065
0
0
26,461,065
86.7%
Healthpartners Inc.
323,110,000
277,786,000
3,880,000
0
281,666,000
91.3%
76,514,000
71,263,000
903,000
0
72,166,000
98.7%
299,272,020
267,717,416
2,715,508
0
270,432,924
90.9%
PreferredOne Health
Plan
36,264,677
32,094,820
363,256
30,196
32,488,272
93.9%
PreferredOne IC
39,155,657
37,352,947
424,368
0
37,777,315
96.9%
1,335,922,839
1,189,037,248
11,831,697
81,401
Healthpartners IC
Medica IC
Total
Source: MDH Health Economics Program analysis of data from National Association of Insurance
Commissioners (NAIC), Supplementary Health Care Exhibit—Part 1 ; Note 1: premiums exclude taxes and fees.
Note 2: Beginning in 2012, federal law requires insurance companies that don’t include certain small and new
companies to issue rebates to consumers for an MLR under 80% in the small group market for the prior year.
2,536,873,185 91.7%
22
Medical Loss Ratio in the Group Market, 2013
(Carriers with $2 million or more in Premium Revenue)
Claims Expense
Net Premium1
BCBSM
Incurred Claims
Quality
Improvement
Fraud
Total
MLR2
1,051,092,006
947,944,693
6,809,048
124,978
954,878,719
91.6%
16,872,124
14,626,747
131,027
1,749
14,759,523
90.6%
7,073,857
6,709,178
35,229
0
6,744,407 100.0%
Federated Mut IC
14,543,933
14,277,854
0
0
14,277,854 102.7%
Group Health Inc.
45,669,000
44,185,000
952,000
0
45,137,000
99.0%
Healthpartners Inc.
313,632,000
250,539,000
2,434,000
0
252,973,000
84.4%
Healthpartners IC
564,402,000
471,256,000
6,406,000
0
477,662,000
89.1%
3,931,079
4,976,761
28,948
0
691,482,013
587,524,258
5,751,170
0
593,275,428
90.4%
PreferredOne Health Plan
23,426,313
21,640,519
289,090
20,367
21,949,976
98.3%
PreferredOne IC
91,261,807
79,169,535
896,600
0
80,066,135
92.3%
2,477,302
2,500,574
22,738
0
2,825,863,434
2,445,350,119
23,755,850
Blue Plus
Connecticut Gen Life IC
Medica Health Plans
Medica IC
Sanford Health Plan
Total
5,005,709 351.2%
2,523,312 109.0%
147,094 2,469,253,063
No data available.
Source: MDH Health Economics Program analysis of data from National Association of Insurance
Commissioners (NAIC), Supplementary Health Care Exhibit—Part 1; Note 1: premiums exclude taxes and fees.
Note 2: Beginning in 2012, federal law requires insurance companies that don’t include certain small and new
companies to issue rebates to consumers for an MLR under 85% in the large group market for the prior year.
90.4%
HMO ENROLLMENT STATISTICS
24
Minnesota HMO Member Months by Product
Line, 2008 to 2013
12,000,000
10,000,000
8,000,000
6,000,000
4,000,000
2,000,000
0
Commercial
PMAP,
PGAMC,
MNCare
Medicare
MSHO,
MDHO, and
SNBC
Other
Total
Minnesota
Products
2008
4,574,441
4,529,156
1,011,580
408,493
46,427
10,570,097
2009
4,157,413
4,926,689
1,179,530
440,547
63,699
10,767,878
2010
3,633,053
5,327,847
1,340,216
671,741
44,805
11,017,662
2011
2,846,525
5,860,173
1,476,138
454,917
62,959
10,700,712
2012
2,279,126
5,761,840
1,543,457
750,187
203,202
10,537,812
2013
2,004,348
6,046,694
1,760,333
888,181
66,746
10,766,302
PMAP is Prepaid Medical Assistance Program; MSHO is Minnesota Senior Health Options; MDHO is Minnesota
Disability Health Options; SNBC is Special Needs Basic Care; All Other includes: Medicare Supplemental, and
Dental.
Source: MDH Health Economics Program analysis of HMO annual reports.
25
Distribution of Minnesota HMO Enrollment by
Region, 2012
Northwest
BluePlus
Northeast
West
Central
Central
Southwest
Southeast
Twin
Cities
Statewide
14,213
16,431
16,294
40,343
25,745
43,383
50,687
207,096
186
721
368
4,431
291
1,929
43,471
51,397
0
0
0
0
0
33
0
33
160
435
349
28,090
2,735
3,182
190,470
225,421
2,015
20,788
7,729
24,165
107
1,056
82,666
138,526
Metropolitan
1
3
0
3
1
1
10,096
10,105
PreferredOne
99
362
630
2,863
985
1,535
8,955
15,429
0
0
0
0
735
15
0
750
3,420
14,614
3,628
27,272
9,632
36,221
207,230
302,017
20,094
53,354
28,998
127,167
40,231
87,355
593,575
950,744
GroupHealth
Gundersen
HealthPartners
Medica
Sanford
Ucare
All HMOs
Source: MDH Health Economics Program analysis of HMO annual reports
26
Minnesota HMO Enrollment as Percent of
Regional Population, 2012
Northwest
Northeast
West
Central
Central
Southwest
BluePlus
8.4%
5.0%
7.3%
5.5%
9.2%
5.9%
1.7%
3.8%
GroupHealth
0.1%
0.2%
0.2%
0.6%
0.1%
0.3%
1.5%
1.0%
Gundersen
0.0%
0.0%
0.0%
0.0%
0.0%
0.005%
0.0%
0.001%
HealthPartners
0.1%
0.1%
0.2%
3.8%
1.0%
0.4%
6.5%
4.2%
Medica
1.2%
6.4%
3.5%
3.3%
0.0%
0.1%
2.8%
2.6%
Metropolitan
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.3%
0.2%
PreferredOne
0.1%
0.1%
0.3%
0.4%
0.4%
0.2%
0.3%
0.3%
Sanford
0.0%
0.0%
0.0%
0.0%
0.3%
0.0%
0.0%
0.0%
Ucare
2.0%
4.5%
1.6%
3.7%
3.5%
5.0%
7.1%
5.6%
All HMOs
11.9%
16.4%
13.0%
17.4%
14.4%
12.0%
20.3%
17.7%
Gundersen Luthern Health Plan is new to the Minnesota market as of 2012.
Source: MDH Health Economics Program analysis of HMO annual reports
Southeast Twin Cities State-wide
27
Minnesota HMO Enrollment as Percent of
Regional Population, 2012
11.9%
16.4%
13.0%
17.4%
20.3%
14.4%
12.0%
Source: MDH Health Economics Program analysis of HMO annual reports; U.S. Census Bureau.
28
Minnesota HMO Enrollment by Firm, 2013
Blue Plus
16.3%
UCare
34.0%
Group Health
6.0%
Sanford
0.1%
HealthPartners
24.8%
PreferredOne
1.8%
Metropolitan
Medica
1.1%
15.9%
Source: MDH Health Economics Program analysis of Minnesota Supplement # 1 available April 1st of
the following calendar year.
Gundersen
0.042%
29
Minnesota HMO Enrollment by Product Line,
2013
MN Seniors Health Options,
MN Disability Health
Options, and SNBC
8.2%
Other
0.6%
Commercial
18.6%
MinnesotaCare
13.6%
Medicare
16.4%
Prepaid Medical Assistance
Program
42.6%
Source: MDH Health Economics Program analysis of Minnesota Supplement # 1 available April 1st of
the following calendar year.
30
Total Minnesota HMO Enrollment, 2006 to 2012
960
951
934
940
915
In Thousands
920
900
894
887
880
870
864
860
840
820
2006
2007
2008
Source: MDH Health Economics Program analysis of HMO annual reports.
2009
2010
2011
2012
31
Minnesota HMO Market Penetration, 2006 to
2012
Source: MDH Health Economics Program analysis of HMO annual report, U.S. Census Bureau.
32
HMO Enrollment in Minnesota by Product Line,
2006 to 2012
Source: MDH Health Economics Program analysis of HMO annual reports.
33
Rates of Enrollment Growth for Minnesota
HMOs by Product Line, 2007 to 2012
Source: MDH Health Economics Program analysis of HMO annual reports.
34
HMO Enrollment in Minnesota by Firm, 2006 to
2012
2006
2007
2008
2009
2010
2011
2012
Blue Plus
151,751
136,204
132,279
136,210
176,357
201,754
207,096
First Plan
10,347
15,573
16,057
11,130
0
Group Health
26,047
23,986
21,634
51,334
48,626
50,827
51,397
Gundersen
-
-
-
-
-
-
33
HealthPartners
334,938
320,734
328,621
286,953
265,930
227,872
225,421
Medica
183,884
179,045
157,957
171,445
192,087
176,692
138,526
MHP
16,941
17,861
21,624
18,662
18,112
19,009
10,105
PreferredOne
48,187
50,022
46,301
37,596
37,440
21,633
15,429
459
419
521
965
813
899
750
UCare
121,875
126,062
139,125
172,259
194,251
215,915
302,017
All HMOs
894,429
869,906
864,119
886,554
933,616
914,601
950,774
(8.8%)
(2.7%)
(0.7%)
2.6%
5.3%
(2.0%)
4.0%
Sanford (Sioux Valley)
Change from previous year
Source: MDH Health Economics Program analysis of HMO annual reports
35
Commercial Enrollment in Minnesota HMOs,
2006 to 2012
2006
2007
2008
2009
2010
Blue Plus
42,649
32,268
26,289
16,302
11,114
9,661
4,998
First Plan
1,285
1,810
1,580
618
0
0
0
23,172
-
22,210
-
16,088
-
15,030
-
11,121
-
10,151
-
8,884
250,881
234,995
245,219
226,436
201,758
157,709
141,152
50,472
50,024
24,615
21,620
16,585
13,160
1,257
0
0
0
0
0
0
0
48,187
50,022
46,301
37,596
37,440
21,633
15,429
438
388
472
683
467
591
473
0
0
0
0
0
0
0
All HMOs
417,084
391,717
360,564
318,285
278,485
212,905
172,226
Change from previous year
(15.3%)
(6.1%)
(8.0%)
(11.7%)
(12.5%)
(23.5%)
(19.1%)
Group Health
Gundersen
HealthPartners
Medica
MHP
PreferredOne
Sanford (Sioux Valley)
UCare
Source: MDH Health Economics Program analysis of HMO annual reports
2011
2012
33
36
Medicare Advantage Enrollment in Minnesota
HMOs, 2006 to 2012
2006
2007
2008
2009
2010
2011
2012
Blue Plus
0
0
0
0
0
0
0
First Plan
0
0
0
0
0
0
0
Group Health
2,875
1,776
1,549
0
0
0
0
Gundersen
-
-
-
-
-
-
0
HealthPartners
0
0
0
839
503
16
31
Medica
0
0
0
0
0
0
0
15
1,018
4,567
218
46
0
0
PreferredOne
0
0
0
0
0
0
0
Sanford (Sioux Valley)
0
0
0
0
0
308
0
UCare
33,827
37,189
44,672
61,960
74,022
82,620
86,237
All HMOs
36,717
39,983
50,788
63,017
74,571
82,944
86,268
Change from previous year
(7.9%)
8.9%
27.0%
24.1%
18.3%
11.2%
4.0%
MHP
Source: MDH Health Economics Program analysis of HMO annual reports
37
Other Medicare Enrollment in Minnesota
HMOs, 2006 to 2012
2006
2007
2008
2009
2010
2011
2012
Blue Plus
12,060
9,520
10,885
10,934
40,406
62,704
82,792
First Plan
838
1,077
1,160
1,263
0
0
0
0
0
3,997
36,304
37,505
40,676
42,513
Group Health
Gundersen
-
-
-
-
-
-
0
HealthPartners
35,574
37,186
35,049
4,424
4,611
4,604
4,769
Medica
11,629
11,194
13,137
14,341
30,462
12,562
25,686
931
836
824
1,015
1,161
1,286
3,373
0
0
0
0
0
0
0
21
31
49
282
346
0
277
8,764
9,437
10,079
10,703
9,526
9,310
24,827
All HMOs
69,817
69,281
75,180
79,266
124,017
131,142
184,237
Change from previous year
68.3%
(0.8%)
8.5%
5.4%
56.5%
5.7%
40.5%
MHP
PreferredOne
Sanford (Sioux Valley)
UCare
*Other Medicare includes Medicare Cost, Minnesota Senior Health Options, Minnesota Disability Health Options
MN Senior Care Plus, and Special Needs Basic Care
Source: MDH Health Economics Program analysis of HMO annual reports
38
Prepaid Medical Assistance Program
Enrollment in Minnesota HMOs, 2006 to 2012
2006
2007
2008
2009
2010
2011
2012
Blue Plus
48,242
49,873
52,162
61,445
66,983
82,200
78,279
First Plan
4,338
7,055
7,692
5,334
0
0
0
0
0
0
0
0
0
0
Group Health
Gundersen
-
-
-
-
-
-
0
HealthPartners
30,616
31,653
32,282
36,325
38,933
49,508
60,953
Medica
86,618
85,891
87,680
97,039
103,288
117,697
86,521
MHP
12,209
12,567
12,851
13,537
14,176
16,207
6.732
PreferredOne
0
0
0
0
0
0
0
Sanford (Sioux Valley)
0
0
0
0
0
0
0
56,230
58,040
62,462
73,064
82,198
101,678
157,011
238,253
245,079
255,129
286,744
305,578
367,290
389,496
(7.8%)
2.9%
4.1%
12.4%
6.6%
20.2%
6.0%
UCare
All HMOs
Change from previous year
Source: MDH Health Economics Program Analysis of HMO Annual Report
39
Prepaid General Assistance Medical Care
Enrollment in Minnesota HMOs, 2006 to 2012
2006
2007
2008
2009
2010
2011
2012
Blue Plus
2,992
1,816
1,962
2,365
0
0
0
First Plan
572
749
755
498
0
0
0
0
0
0
0
0
0
0
Group Health
Gundersen
-
-
-
-
HealthPartners
3,737
2,718
3,020
3,738
0
0
0
Medica
7,081
4,886
5,240
6,342
0
0
0
MHP
2,004
1,484
1,524
1,690
0
0
0
PreferredOne
0
0
0
0
0
0
0
Sanford (Sioux Valley)
0
0
0
0
0
0
0
4,341
3,166
3,711
4,773
0
0
0
All HMOs
20,727
14,819
16,212
19,406
0
0
0
Change from previous year
(7.7%)
(28.5%)
9.4%
19.7%
(100.0%)
0.0%
0.0%
UCare
-
*The Prepaid General Assistance Medical Care program has been discontinued, and this slide will not be
included in subsequent years.
Source: MDH Health Economics Program analysis of HMO annual reports
-
0
40
MinnesotaCare Enrollment in Minnesota
HMOs, 2006 to 2012
2006
2007
2008
2009
2010
2011
2012
Blue Plus
45,808
42,727
40,981
45,164
57,854
47,189
41,027
First Plan
3,314
4,882
4,870
3,417
0
0
0
0
0
0
0
0
0
0
Group Health
Gundersen
-
-
-
-
-
-
0
HealthPartners
14,130
14,182
13,051
15,191
20,125
16,035
18,516
Medica
28,083
27,050
27,285
32,103
41,752
33,273
25,062
1,782
1,956
1,858
2,202
2,729
1,516
0
PreferredOne
0
0
0
0
0
0
0
Sanford (Sioux Valley)
0
0
0
0
0
0
0
18,713
18,230
18,201
21,759
28,505
22,307
33,942
111,830
109,027
106,246
119,836
150,965
120,320
118,547
(9.0%)
(2.5%)
(2.6%)
12.8%
26.0%
(20.3%)
(1.5%)
MHP
UCare
All HMOs
Change from previous year
Source: MDH Health Economics Program analysis of HMO annual reports
41
Minnesota HMO Enrollment* by Firm and Age,
2012
<15
BluePlus
15-29
30-44
45-54
55-64
65+
Total
20.0%
17.9%
16.2%
14.8%
14.6%
33.4%
21.6%
Group Health
0.3%
0.9%
0.7%
2.3%
8.8%
17.1%
5.5%
Gundersen
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
0.0%
HealthPartners
25.1%
31.2%
36.5%
39.4%
36.5%
2.8%
24.3%
Medica
19.3%
16.9%
16.4%
16.1%
14.5%
5.8%
14.4%
Metropolitan
0.0%
1.3%
1.9%
2.8%
2.1%
0.6%
1.0%
PreferredOne
1.2%
2.2%
2.9%
3.4%
2.9%
0.1%
1.7%
Sanford
0.0%
0.1%
0.1%
0.1%
0.2%
0.1%
0.1%
34.1%
29.6%
25.4%
21.3%
20.3%
40.1%
31.4%
100.0%
100.0%
100.0%
100.0%
100.0%
100.0%
100.0%
UCare
All HMOs
*Includes health plan members that are non-Minnesota residents.
Source: MDH Health Economics Program analysis of HMO annual reports.
42
Distribution of Minnesota HMO Enrollment* by
Product Line and Age, 2012
*Includes health plan members that are non-Minnesota residents.
Source: MDH Health Economics Program analysis of HMO annual reports.
43
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