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Trends and Indicators in the Changing Health Care Marketplace
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Exhibit 2.14: State HMO Penetration, 2004
HMO penetration – the percent of a state’s population enrolled in an HMO – varied strikingly across states in 2004, ranging from a low of less than 2% in Alaska (0%), Mississippi (0.1%), and North Dakota (0.3%), to highs of 47.8% in California, 37.0% in Connecticut, and 36.8% in Massachusetts. The total U.S. HMO penetration rate was 23.0% in 2004.

State

State Penetration

 

State

State Penetration

Alabama

2.2%

 

Montana

8.8%

Alaska

0.0%

 

Nebraska

5.8%

Arizona

14.9%

 

Nevada

24.4%

Arkansas

4.5%

 

New Hampshire

14.3%

California

47.8%

 

New Jersey

23.4%

Colorado

25.9%

 

New Mexico

29.5%

Connecticut

37.0%

 

New York

27.1%

Delaware

13.9%

 

North Carolina

7.5%

District of Columbia*

165.5%

 

North Dakota

0.3%

Florida

23.8%

 

Ohio

15.5%

Georgia

12.9%

 

Oklahoma

7.3%

Hawaii

29.6%

 

Oregon

19.5%

Idaho

2.8%

 

Pennsylvania

32.0%

Illinois

14.6%

 

Rhode Island

31.1%

Indiana

11.1%

 

South Carolina

5.4%

Iowa

9.0%

 

South Dakota

9.8%

Kansas

6.8%

 

Tennessee

11.8%

Kentucky

10.5%

 

Texas

9.4%

Louisiana

10.1%

 

Utah

26.5%

Maine

18.6%

 

Vermont

9.7%

Maryland

24.2%

 

Virginia

12.9%

Massachusetts

36.8%

 

Washington

13.6%

Michigan

26.8%

 

West Virginia

10.0%

Minnesota

26.3%

 

Wisconsin

28.2%

Mississippi

0.1%

 

Wyoming

2.0%

Missouri

24.5%

 

 

 

 

Notes: HMO enrollment includes enrollees in both traditional HMOs and point-of-service (POS) plans through: group/commercial plans, Medicare, Medicaid, the Federal Employees Health Benefits Program, direct pay plans, and unidentified HMO products. State penetration was calculated by InterStudy using state population from the U.S. Census Bureau as of July, 2004. *District of Columbia plans' lives include lives for surrounding states.

Source: HealthLeaders-Interstudy, The Competitive Edge, Spring 2005, Part II: Managed Care Industry Report, June 2005, Table 12, p.42 (state data) and Figure 9, p.47 (total U.S. data), using data as of July 1, 2004.

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Trends and Indicators in the Changing Health Care Marketplace
Information provided by the Health Care Marketplace Project.

Publication Number: 7031
Information Updated: 03/15/06

 

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