Medicare Compliance & Reimbursement

Standouts dominate individual PDP and MA-PDP markets.

Only two insurers have managed to capture double-digit market shares of this year's Medicare Part D drug plan enrollees.

UnitedHealth Group bagged the lion's share of the Part D enrollee market, according to a recent announcement from the Centers for Medicare & Medicaid Services. United's lucrative marketing relationship with AARP helped it trounce the competition and secure 3.8 million standalone drug plan enrollees to date--27 percent of the current enrollee market share. United also claimed 20 percent of the market share for Medicare Advantage plans that include prescription drug coverage.

The leading non-national carrier, Humana, came in second, enrolling 2.4 million beneficiaries in its standalone drug plans to date--18 percent of the current enrollee market. Humana was able to attract enrollees with nominal drug costs by offering them low monthly premiums.

But Kaiser Permanente nudged Humana out of the MA-PDP number-two spot by staking claim to 14 percent of the current enrollee base. Humana instead placed third in MA-PDP enrollment, bringing on board about 13 percent of the overall enrollees.

Consolidation among insurers could play a critical role in the direction that PDP premium costs take going forward. Currently, 10 companies dominate 80 percent of the PDP enrollee market, according to CMS data. In both the PDP and the MA-PDP markets, nearly half of current enrollees have coverage through one of just three companies.

The companies that secure large enrollment numbers early on will have a big marketing advantage going into the second year, Avalere Health president Dan Mendelson told reporters.

In the long run, the high degree of concentration among a relatively smaller number of plans will help produce market stability and concentration, projects Mendelson. The leading plans will probably be able to leverage better prices over some period of time, which could help keep premiums low, he notes.

For complete enrollment figures, go to www.cms.hhs.gov/PrescriptionDrugCovGenIn/02_EnrollmentData.asp.