Last week at the Medicaid Health Plans of America‘s (MHPA) Annual Convention, we attended a great breakout session on the “State of Medicaid” by Ari Gottlieb and Augustin Ruta. Gottlieb is a Principal at A2 Strategy Group and a former Director in the health strategy practice at PwC and Strategy& and he’s always a highlight of the MHPA conference for us. This year was no exception. His session was full of great information regarding the state of Medicaid in 2018 and we thought we’d highlight a few of our favorite points. Here are 5 things to know about the State of Medicaid in 2018:

1. Due to the improving economy, a lack of new expansion implementation, and heightened eligibility management, overall Medicaid enrollment in 2018 declined for the first time in several years. Currently, 74.2 million Americans, or 22.8% of the US population, receive Medicaid benefits. Those numbers are down 1.1 million from 2017.
2. Enrollment in private Medicaid health plans continues to grow. 54.9 million Americans, or 74% of total beneficiaries, are now covered by private managed Medicaid health plans. In 2013, enrollment in private Medicaid health plans was just 59.4% of total enrollees.
3. Over the last year, Montana continued to be the biggest beneficiary of Medicaid expansion, with a 137% increase in enrollment. Since 2013, nearly one in seven Montanans has joined Medicaid, the most in the nation. 
4. In the last 12 months, no additional states implemented Medicaid expansion, but both Virginia and Maine are expected to expand Medicaid enrollment in 2019. Virginia has already authorized the expansion, effective January 2019, and Maine is predicted to move forward with expansion in 2019 following a change in control of the Governorship.
5. The trend of consolidation in the private Medicaid health plan market continues with the loss of 15 plans in 2018 (leaving us with 152 private plans). As plans consolidate, plan territories are beginning to increase. While the vast majority of plans (87%) are single-state, 20 plans now operate in two or more states. This also means larger plans – only 58 plans now have less than 50,000 Medicaid members – the average plan has increased by nearly 50% since 2013.

To find out more about the State of Medicaid and to download the full report, visit https://a2strategy.com/.