The Facts of Managed Care

MCOL January 10, 2020
Clive Riddle

The MCOL Managed Care Fact Sheets have just been updated, an ongoing online feature provided since the 1990s. Here’s some highlights:

Overall national managed care penetration is now 75.4%. Here’s a breakdown by payor segment, based on 2019 data:

Sources: (see Note 1)

Here is the total national managed care enrollment by coverage type, based on 2018 data:

Health Maintenance Organization (HMO): 94.8 million

Preferred Provider Organization (PPO): 165.8 million

Point of Service (POS): 4.8 million

High Deductible Health Plan (HDHP): 15.6 million

Total* 81.0 million

* The above total enrollment exceeds the total actual national managed care population due to double counting of A) spouses and dependents who have dual coverage; and B) HDHP plans that are also...

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