Report: Medicare Advantage growth gives way to SNPs

Medicare Advantage enrollment growth is continuing its downward trend, with new Chartis numbers showing enrollment grew only 2.5% this year, compared to the 3.6% seen in 2025 and the historic 7% growth in the early 2020s.

All said, Medicare Advantage enrollment sits at 35.4 million people, or 51% of the whole Medicare population, the Chartis report showed.

Still, enrollment is generally considered sluggish, and in fact declined in seven states, including Vermont, Wyoming, New Hampshire, Idaho, Minnesota, Maryland, and South Dakota.

These trends are more indicative of a change in plan offerings, as opposed to beneficiary preferences.

For-profit health plans have made it clear they intend to slow growth and scale back membership to maximize margins, leading some to exit the Medicare Advantage market altogether. Total plan offerings fell by 2.5% for the third straight year, Chartis said. Meanwhile, other plans have opted to reduce their footprints or their benefits offerings.

That's led to growth happening in other types of plans, including Special Needs Plans (SNPs). This year, SNP enrollment increased by 12.2%. This was driven in large part by Chronic Condition SNPs (CSNPs), for which enrollment increased by 49%.

SNP enrollment is still largely concentrated among the top five health plans, specifically UnitedHealth Group, Humana, Elevance Health, CVS Health and Kaiser Foundation Health Plan.

But the number of beneficiaries seeking SNP plans from smaller payers is ticking up, at least modestly. While 27% selected a smaller SNP plan in 2025, 29% did so this year. Chartis said plans such as Devoted, CareSource and Molina are starting to emerge in the market.

Chartis also flagged changes in the traditional Medicare space. Specifically, this year is the first in which Medicare Advantage growth did not stifle traditional Medicare growth, the report showed. This year, traditional Medicare enrollment increased by 600,000 beneficiaries, the biggest margin of growth since 2023.

In addition to enrollment numbers, the Chartis report flagged changes in enrollment by star rating.

The number of beneficiaries enrolled in plans with four or more stars declined from 80% earlier in the 2020s to just 67% in 2026. Notably, the share of people in a plan rated five stars shrank from 26% in 2022 to just 2% in 2026.

This comes as average star ratings held relatively steady between 2025 and 2026. Still, those ratings follow years of declines starting in 2022, Chartis said in an October report on the 2026 star ratings data.

Because star ratings have financial implications, the Chartis researchers indicated that poor performance might be straining payers. In turn, payers may not be able to invest in benefits that "make products more attractive," the authors said, potentially affecting member growth.

The report authors suggested the Medicare Advantage space could see further retrenchment moving forward. Most in the industry expect Medicare Advantage growth to decrease or at least remain the same next year, while most plan leaders anticipate a decline in benefits in 2027, too.

Still, the five-year outlook is more positive, with 54% of Medicare Advantage leaders saying they view their long-term forecast positively.

But to move forward sustainably, health plans must be strategic, the report authors said.

They must make strategic decisions to pull -- or not pull -- Medicare Advantage plans from the market. Adopting a long-term profitability mindset, continuously evaluating return on investment and engaging in proactive federal policy will be key.

Finally, plans must consider provider partnerships that drive impact, not just scale, the authors concluded.

Sara Heath has reported news related to patient engagement and health equity since 2015.