Public Use Sources for Managed Care Enrollment and Penetration Rates

Purpose

Medicare managed care enrollment has fluctuated over the years and is a frequently requested statistic. Often researchers are interested in penetration rates or the percentage of Medicare beneficiaries enrolled in a Medicare managed care plan. These plans are also referred to as Medicare Part C, Medicare Advantage (MA), or Medicare Health Maintenance Organizations (HMOs).
Current Version Date:
11/02/2023
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Sources of Penetration Rate Data on the CMS Website

The CMS website has two sections that provide Medicare managed care enrollment information that can be used to calculate penetration rates depending on the year(s) of interest.

2006 to Current

For the latest data available, the Medicare Advantage (MA) / Part D Contract and Enrollment Data web page provides publicly available data on contracts and plans, enrollment numbers, service area data, and contact information for MA, Prescription Drug Plan (PDP), cost, PACE, and demonstration organizations. Information is available at the state, county, and contract level. These reports are updated monthly and many are available for the most current month back to mid-2006. Part D program data for 2006 and 2007, however, may not be available in the same time increments as later years.

2005 and Earlier

For data years 2005 and earlier, use the reports found on the CMS Health Plans, Reports, Files and Data web page.

Other Sources

The Peterson-KFF Health System Tracker has an easy to use online tool that allows you to compare Medicare enrollment, including penetration rate, at the state, county, MSA, and MA region. The tool includes information from 1999 through the current year.

 

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Article Information

Author:
Faith Asper, MHS, CIPP/G
Level:
Introduction
Program:
Medicare
Category:
Medicare Encounter
Disclaimer:
The process and materials mentioned as part of this KnowledgeBase article are current, as of the publication date on the article, to the best of our knowledge. The examples provided are correct in the aggregate but may not apply to every subgroup or circumstance that a researcher may wish to study. It is up to the researcher to conduct analysis and confirm that the patterns described in this KnowledgeBase article apply to his/her particular study. If your research findings appear to contradict the advice provided, please contact ResDAC at resdac@umn.edu.