Texas HMOs Set Enrollment Record

Margaret Dick Tocknell, for HealthLeaders Media , October 16, 2013

Medicaid and Medicare Advantage plans are the primary drivers of a resurgence in health maintenance organizations in the Lone Star state, where Medicare Advantage HMOs enjoyed double-digit enrollment growth in 2012.

After several years of membership losses, Texas health maintenance organizations are enjoying something of a resurgence with enrollment hitting a record four million members according to the Texas Health Market Review 2013.

The primary drivers? Medicaid and Medicare Advantage plans. Yep, although Texas officials may rail against government programs, HMOs there have been busy expanding their markets and setting up networks to grab a larger membership share of those government programs.

In terms of enrollment, the largest HMOs in the Lone Star state are national Medicaid plans—AmeriGroup (661,478 members) and Centene (410,512 members)—and the Texas Children's Health Plan (354,684), which covers members who are part of the federal Children's Health Insurance Plan.

What is happening in Texas?

Allan Baumgarten, a Minneapolis-based consultant who has studied the Texas market for more than a decade and is the author of the market review, says the state has been busy in recent years transitioning its elderly and disabled Medicaid recipients into managed care arrangements.

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