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South Florida accountable care organization (ACO) enrollment declined 24% between 2018 and 2021 year-end according to Centers for Medicare & Medicaid Services (CMS) data. Over the same period:
- Miami-Dade County showed the largest decline (40%) from 29,123 enrollees to 17,378.
- Broward County enrollment dropped (21%) from 42,032 to 33,008.
- Plam Beach county enrollment declined (21%) from 85,298 to 67,807.
The loss in ACO enrollment in South Florida is significantly higher than for the state (-5%) overall. Within the state’s remaining two major population centers, Orange County enrollment declined by 39% between 2018 and 2022, but Hillsborough County enrollment grew by 58%.
ACO enrollment comprises only traditional/original Medicare fee-for-service patients. ACOs with service areas heavily penetrated by Medicare Advantage plans face significant growth headwinds. Consider as of July 2023, over three-quarters of Miami-Dade County’s 496,000 Medicare beneficiaries have Advantage Plan health insurance. In contrast, 64% of Medicare eligibles have an Advantage Plan in Broward County and 47% in Palm Beach County.