Medicaid Enrollment: May Attrition Remains Elevated, 2Q Accelerating QoQ

Research evidence excerpt

Medicaid Enrollment: May Attrition Remains Elevated, 2Q Accelerating QoQ

at our q/q growth estimate.

Same-Footprint Growth Understanding: Company-reported “organic” disenrollment likely•

overstates underlying churn. Company disclosures adjust for M&A and RFP activity, which

we agree with. But, when the company gives a disenrollment % that is an average over time

(e.g. 8% organic disenrollment in '24), we think the denominator is inflated (and therefore,

disenrollment is inflated) by including short-tenure and auto-assigned members. This dynamic

appears particularly true during redetermination. It also obfuscates acuity trends, as members

roll off before utilization materially affects acuity; their temporary inclusion inflates reported

enrollment and mechanically elevates disenrollment. All-in, we view company-reported figures

as an upper bound and see our normalized same-footprint metrics as better capturing MLR

dynamics.

Modeling Assumptions to Standardize Data Across States: The base data underpinning the•

charts above were sourced from state Medicaid websites. For the states that do not provide

enrollment by program (or other granularity that we need) for an individual carrier, enrollment was

sourced using NAIC codes that correlated with the Medicaid plan offered by that specific MCO

in that state.

Our ability to sort and analyze enrollment was dictated by the depth to which each state broke•

out its Medicaid population.

To the extent possible, we used the program detail provided by each state to categorize •

MCO state level populations into the aforementioned groups.

While some states provided a more detailed program breakout than others, this •

is normalized across carriers.

For states that provide total enrollment by MCO and separately provide •