What are competitors bringing to market, and where is the message space?
Structure is public. Benefits are not, yet. Carrier share, concentration, plan and contract counts and integration mix all come from named CMS files and are on this page. Premium, MOOP, supplemental benefits and Part B giveback come from the MA Landscape and Plan Benefit Package files, which this site has not ingested. Rather than approximate them, this page marks them as missing and says what they would change.
National SNP carrier structure
| Parent organization | SNP enrollment | Share | Contracts |
|---|---|---|---|
| UnitedHealth Group | 3,015,652 | 35.7% | 47 |
| Other / independent | 2,335,438 | 27.7% | 238 |
| Humana | 983,270 | 11.7% | 18 |
| CVS Health / Aetna | 832,639 | 9.9% | 33 |
| Elevance Health | 376,797 | 4.5% | 15 |
| Centene | 219,621 | 2.6% | 33 |
| Kaiser Permanente | 155,047 | 1.8% | 5 |
| Devoted Health | 147,787 | 1.8% | 31 |
| Molina Healthcare | 140,159 | 1.7% | 17 |
| SCAN | 89,897 | 1.1% | 6 |
| Alignment Healthcare | 84,187 | 1.0% | 5 |
| Blue Cross Blue Shield (other) | 52,121 | 0.6% | 6 |
Share of 8,437,333 SNP enrollees in the August 2026 CMS SNP Comprehensive Report. "Other / independent" aggregates parents CMS reports individually below the reporting threshold used on the SNP page, and is shown rather than dropped so the shares sum honestly.
Where D-SNP enrollment is most concentrated
| State | HHI | Largest carrier | Its share | Carriers | FIDE + HIDE | Unattributed |
|---|---|---|---|---|---|---|
| District of Columbia | 10,000 | UnitedHealth Group | 100.0% | 1 | 58.5% | 0.0% |
| Minnesota | 10,000 | Other / independent | 100.0% | 1 | 100.0% | 0.0% |
| Wyoming | 10,000 | UnitedHealth Group | 100.0% | 1 | 0.0% | 0.0% |
| Arizona | 9,945 | Other / independent | 99.7% | 2 | 100.0% | 0.0% |
| Oregon | 7,502 | Other / independent | 85.4% | 2 | 97.6% | 0.0% |
| South Dakota | 6,998 | UnitedHealth Group | 81.6% | 2 | 0.0% | 0.0% |
| Montana | 6,891 | Humana | 80.7% | 2 | 0.0% | 0.0% |
| North Dakota | 6,779 | UnitedHealth Group | 79.8% | 2 | 0.0% | 0.0% |
| Kansas | 6,495 | UnitedHealth Group | 79.1% | 3 | 91.5% | 0.0% |
| Indiana | 5,988 | UnitedHealth Group | 72.2% | 2 | 45.5% | 0.0% |
| Nebraska | 5,862 | UnitedHealth Group | 75.3% | 6 | 84.5% | 0.0% |
| Puerto Rico | 5,849 | Other / independent | 70.6% | 2 | 100.0% | 0.0% |
| Washington | 5,489 | UnitedHealth Group | 72.3% | 5 | 46.7% | 0.0% |
| North Carolina | 5,260 | UnitedHealth Group | 68.9% | 8 | 0.0% | 0.0% |
| Idaho | 5,178 | Molina Healthcare | 59.4% | 2 | 76.4% | 0.0% |
| Massachusetts | 5,145 | Other / independent | 66.9% | 3 | 100.0% | 0.0% |
| Tennessee | 5,118 | UnitedHealth Group | 57.7% | 2 | 48.7% | 0.0% |
| Pennsylvania | 5,049 | Other / independent | 66.1% | 5 | 30.0% | 0.0% |
| Hawaii | 5,042 | UnitedHealth Group | 67.1% | 4 | 100.0% | 0.0% |
| Delaware | 5,012 | Highmark | 52.5% | 2 | 68.3% | 0.0% |
Top 20 states by concentration. HHI is computed over parent organizations using single-state D-SNP plans only; the unattributed column is the share of state D-SNP enrollment sitting in multi-state plans that CMS does not split by state. A high unattributed share means the concentration figure beside it is less reliable, which is why it is shown.
Competitive positioning matrix: what can be argued today
| Positioning axis | Status on this site | Available |
|---|---|---|
| Benefit table stakes What every serious competitor in the market already offers. | Not yet computable. Requires the MA Landscape and Plan Benefit Package files. | not yet |
| Differentiation space Benefit or service positions no local competitor currently holds. | Not yet computable for benefits. Structurally visible today only where integration category differs: in a coordination-only market, a HIDE or FIDE product is a real difference a competitor cannot claim. | partial |
| Quality advantage Where a star rating supports a claim. | Not yet computable. Requires contract-level Star Ratings joined to geography. Star claims are contract-specific and plan-year-specific, so this one cannot be approximated. | not yet |
| Price and cost-sharing advantage Premium, MOOP, Part B giveback and cost-sharing position. | Not yet computable. Requires the Landscape and PBP files. | not yet |
| Structural position Share, concentration, plan count and integration mix. | Computable today from the SNP Comprehensive Report and the county enrollment file. It is the part of positioning that does not depend on benefit detail. | available |
Three of five axes wait on the same two CMS files. That is the honest state of competitive benefit intelligence here, and it is the highest-value pipeline on the roadmap for this section.
So what / Now what Interpretation
Structural concentration is a usable positioning input on its own. A market where one parent holds more than half of attributable D-SNP enrollment behaves differently from a fragmented one: the incumbent sets the benchmark shoppers compare against, brokers organise around it, and a challenger has to give a reason to move rather than a reason to choose. Integration mix is the second structural lever, and unlike benefits it is checkable today.
- Use concentration to set the ambition, not the message. High-HHI markets need a switching reason; fragmented markets reward reach and consideration.
- Check integration category state by state before writing anything about coordinated or integrated care.
- Hold benefit comparison claims until the Landscape and PBP ingest lands. An approximate benefit claim is the one mistake in this category that reliably becomes a compliance issue.
- For carrier-level selling points a rep can cite today, the battlecards already carry per-fact vintages.
Limitations you should carry into the meeting
- Four of the nine MA components are not yet computable. The score therefore measures market attractiveness for marketing investment, not competitive winnability.
- D-SNP capture, competitive openness and integration readiness are published by CMS at state level. Applying them to a county assumes the county behaves like its state.
- Carrier concentration attributes only single-state D-SNP plans. Plans sold across several states carry one CMS enrollment figure that cannot be split by state; the unattributed share is reported per state.
- Counties below the reliability floor are flagged, not hidden.
- Nothing here describes an individual beneficiary. Every figure is a published geography-level aggregate.
- National D-SNP capture is computed on the same basis as /market/snp/ (all state rows, Puerto Rico included). Puerto Rico's own ratio is suppressed everywhere it would be displayed, because block-grant Medicaid makes its dual denominator non-comparable.
Sources and vintage
| Dataset | Source | Vintage | Status |
|---|---|---|---|
| MA and other health plan enrollment and share by county | CMS Medicare Monthly Enrollment (BENE_GEO_LVL=County) | April 2026 | live |
| Dual-eligible counts by county | CMS Medicare Monthly Enrollment (DUAL_TOT_BENES / FULL_DUAL_TOT_BENES) | April 2026 | live |
| SNP enrollment, integration and plans | CMS SNP Comprehensive Report (SNP_REPORT_PART_17) | August 2026 | live |
| Marketing Opportunity Score | Derived, tools/build_marketing_data.py v0.1 | 2026-08-26 | modeled |
Full methodology: Marketing Opportunity Score · site methodology.