As the role of private plans in the future of Medicare becomes a focal point of change, policymakers need a better understanding of current trends in private plan choice. This publication profiles the trends in Medicare choices and private plan enrollment since 1999, showing declining enrollment despite growing diversity in choice. Current trends in coordinated care plans show (1) reduced choice, as well as declining benefits and higher premiums for enrollment accounting for declining enrollments; (2) enrollment in private plans remains concentrated in coordinated care plans, particularly HMOs, despite authority for other kinds of options and a targeted PPO demonstration; (3) plans are largely based in urban areas, but choice is eroding even in these areas; and (4) penetration of plans remains uneven across the country.
