Illinois sees growth in new Medicare Advantage plans

An untapped market and an aging population are among the factors driving a wave of new Medicare Advantage plans in Illinois, experts tell Health News Illinois.

In recent months, AMITA Health, OSF HealthCare, CountyCare Health Plan, the American Medical Association, Minneapolis-based Bright Health and Milwaukee-based iCare have announced new plans in the state.

“If you look across the country, Medicare Advantage is probably the hottest marketplace, the one with the most activity,” said Dr. Eric Whitaker, a former state public health director who is working with the American Medical Association’s innovation arm to launch Zing Health. “And given the dysfunction in D.C., Medicare Advantage is actually one of the few things where there is bipartisan support.”

As of November 2018, Medicare Advantage membership stood at over 21.6 million nationally, representing 34 percent of the 63.7 million Americans eligible for Medicare, noted an analysis by Mark Farrah Associates.

There were 489,301 Illinoisans enrolled in Medicare Advantage plans in 2018, according to data from the Kaiser Family Foundation. The number of enrollees was up more than 7 percent from the previous year.

Illinois’ total enrollment lags behind other states with large populations. California had more than 2.4 million people enrolled in Medicare Advantage plans in 2018, while Texas had more than 1.4 million enrollees, Florida had 1.9 million enrollees, New York had more than 1.3 million enrollees and Pennsylvania had more than 1 million enrollees.

Regan Murphy, vice president of managed care programs at Oak Street Health, a Chicago-based network of primary care clinics serving Medicare patients, said companies likely see opportunity in an untapped market.

“There are new plans entering markets everywhere, but given the capital needed to get a Medicare Advantage plan off the ground and a large number of Medicare eligibles, Chicago is an interesting strategic place to start and prove out a model,” Murphy said.

The Mark Farrah Associates’ analysis found 382,515 Medicare Advantage enrollees in the Chicago metropolitan area as of last November. By comparison, the New York City metropolitan area had more than 1 million enrollees, Los Angeles’ metro area had 976,559 enrollees and Miami’s metro area had 615,645 enrollees.

But not all of the new plans will focus on the Chicago market.

OSF HealthCare’s MedAdvantage plans will be available in 17 counties across central and northern Illinois where the health system has a presence.

ICare is dipping into the Rockford area after hearing from providers who wanted more options, said Kirk Heminger, director of marketing. He said further research showed a market with “light options” for consumers near the Illinois-Wisconsin border.

Murphy said the next few years will be telling on whether more organizations decide to enter the market.

“Existing Chicago payers… have been trying to increase Medicare Advantage penetration rate for some time,” Murphy said. “However, newer Medicare eligibles may be more comfortable and excited about product design, network design, member experiences, etc.”

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