Skip to main content
Sister Publication Links
  • ESG: THE NEW IMPERATIVE
Subscribe
  • Sign Up Free
  • Login
  • Subscribe
  • News
    • Current News
    • COVID-19
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Transformation
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Digital Health
  • Insights
    • ACA 10 Years After
    • Best Practices
    • Special Reports
    • Innovations
  • Opinion
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
  • Events & Awards
    • Awards
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Excellence in Governance
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top 25 Innovators
    • Diversity in Healthcare
      • - Luminaries
      • - Top 25 Diversity Leaders
      • - Leaders to Watch
    • Women in Healthcare
      • - Luminaries
      • - Top 25 Women Leaders
      • - Women to Watch
    • Digital Health Transformation Summit
    • Leadership Symposium
    • Social Determinants of Health Symposium
    • Women Leaders in Healthcare Conference
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Diversity Leaders Gala
    • Top 25 Women Leaders Gala
    • - Hospital of the Future
    • - Value Based Care
    • - Supply Chain
    • - Hospital at Home
    • - Workplace of the Future
    • - Digital Health
    • - Future of Staffing
    • - Hospital of the Future (Fall)
  • Multimedia
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Video Series - The Check Up
    • Sponsored Video Series - One on One
  • Data Center
    • Data Center Home
    • Hospital Financials
    • Staffing & Compensation
    • Quality & Safety
    • Mergers & Acquisitions
    • Data Archive
    • Resource Guide: By the Numbers
    • Surveys
    • Data Points
  • MORE +
    • Contact Us
    • Advertise
    • Media Kit
    • Newsletters
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Insurance
August 03, 2022 05:05 PM

HCSC doubles down on Medicare Advantage as market share declines

Nona Tepper
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print
    A younger woman provider helping an older woman on a tablet.
    UnitedHealth Group

    Health Care Service Corp. plans to expand its Medicare Advantage business into another 150 counties next year as the insurer seeks to gain a foothold in an increasingly competitive market for private Medicare plans. 

    The expansion represents the largest in the history of the not-for-profit company, which sells Blue Cross and Blue Shield plans in Illinois, Montana, New Mexico, Oklahoma and Texas. The insurer must obtain clearance from the Centers for Medicare and Medicaid Services to offer Medicare Advantage policies in these new counties.

    “There might be no more competitive space in all of health insurance than Medicare Advantage,” said Nathan Linsley, the company's senior vice president of government and individual markets. “We see significant competition both from national carriers and we've also seen a lot of competition from newer entrants.”

    HCSC also broadened the geographic reach of its Medicare Advantage operations last year when it ventured into 90 new counties. That helped the company increase Medicare Advantage membership by 10,000 to 120,000 as of Jan. 1, according to Chartis Group data.

    Despite that growth, HCSC's Medicare Advantage market share fell to 3.4% at the start of the year, down from 4.4% in 2019, according to the Chartis Group. The insurer counts nearly 7.5 million members across its business lines. 

    “Their presence is mostly in the commercial space and, like so many of the Blues, they've not really seen measurable enrollment in Medicare products,” said Nick Herro, a principal at the Chartis Group. 

    Blue Cross and Blue Shield plans’ Medicare Advantage market share shrank from 15.4% in 2019 to 13.9% this year, Chartis Group data show. National carriers such as UnitedHealth Group's UnitedHealthcare, Centene and CVS Health’s Aetna captured the customers Blues plans lost, the consulting company found.

    Blues plans face a disadvantage compared with national companies because, in many cases, the Blue Cross and Blue Shield Association limits member plans’ geographic reach, Herro said. Expanding to new regions has been key to the growth strategies for-profit Medicare Advantage insurers have executed, he said. 

    “There's different ways to grow outside of those constraints, but their options are less than a for-profit plan or a national plan,” Herro said.

    In the five states where it operates, HCSC seeks to differentiate itself by offering plans that require no out-of-pocket costs, Linsley said. HCSC also aims to claim space in the crowded market by focusing on rural and underserved counties, he said. The company expects double-digit percentage growth in Medicare Advantage enrollment next year.

    Medicare Advantage plans have attracted a smaller share of Medicare beneficiaries in rural areas than in metropolitan areas, in part because of patient concerns about narrow networks, said Ari Gottlieb, a principal at A2 Strategy Group. Some insurers likewise have been reluctant to enter rural Medicare Advantage markets because there are so few providers, he said.

    “If you're the only hospital in town, [you] start from a stronger negotiating position than [in] competitive urban markets, and that's going to influence product design and benefit offerings,” Gottlieb said.

    Less competition in rural regions has translated to less generous Medicare Advantage benefits, which also makes the privatized form of Medicare less attractive, Gottlieb said. But that may be changing.

    As the Medicare Advantage market gets increasingly competitive, newer entrants are looking at rural markets as a way to compete with national rivals, Gottlieb said. Insurtechs Clover Health and Alignment Healthcare, both of which recently announced expansion plans focused primarily on rural communities, are examples, he said.

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    medicare-advantage-CMS-audits
    More MA insurer audits mean more scrutiny on providers
    medicare advantage directories
    Provider directories are a mess. CMS' plan to fix them has few fans
    Most Popular
    1
    More healthcare organizations at risk of credit default, Moody's says
    2
    Centene fills out senior executive team with new president, COO
    3
    SCAN, CareOregon plan to merge into the HealthRight Group
    4
    Blue Cross Blue Shield of Michigan unveils big push that lets physicians take on risk, reap rewards
    5
    Bright Health weighs reverse stock split as delisting looms
    Sponsored Content
    Daily Finance Newsletter: Sign up to receive daily news and data that has a direct impact on the business and financing of healthcare.
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2023. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • COVID-19
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Digital Health
    • Insights
      • ACA 10 Years After
      • Best Practices
      • Special Reports
      • Innovations
    • Opinion
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Events & Awards
      • Awards
        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Excellence in Governance
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top 25 Innovators
        • Diversity in Healthcare
          • - Luminaries
          • - Top 25 Diversity Leaders
          • - Leaders to Watch
        • Women in Healthcare
          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Conferences
        • Digital Health Transformation Summit
        • Leadership Symposium
        • Social Determinants of Health Symposium
        • Women Leaders in Healthcare Conference
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Diversity Leaders Gala
        • Top 25 Women Leaders Gala
      • Virtual Briefings
        • - Hospital of the Future
        • - Value Based Care
        • - Supply Chain
        • - Hospital at Home
        • - Workplace of the Future
        • - Digital Health
        • - Future of Staffing
        • - Hospital of the Future (Fall)
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • Data Center
      • Data Center Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
      • Mergers & Acquisitions
      • Data Archive
      • Resource Guide: By the Numbers
      • Surveys
      • Data Points
    • MORE +
      • Contact Us
      • Advertise
      • Media Kit
      • Newsletters
      • Jobs
      • People on the Move
      • Reprints & Licensing