CONGRESSIONAL BUDGET OFFICE Peter R. Orszag, Director

U.S. Congress

Washington, DC 20515

www.cbo.gov

April 17, 2007

Honorable Ron Wyden

United States Senate

Washington, DC 20510

Dear Senator:

At your request, the Congressional Budget Office has prepared the attached

table, which summarizes at the state level the number of Medicare

beneficiaries enrolled in group plans and the relationship between the

Medicare Advantage benchmarks and per capita costs in the fee-for-service

sector.

I hope this information is helpful to you. The CBO staff contact for further

information is Tim Gronniger.

Sincerely,

Peter R. Orszag

Attachment

Identical letter sent to the Honorable Max Baucus.
Medicare Advantage Statistics by State, April 20071

State

Total Enrollment in

Group Plans

Average Projected per

Capita Cost in Fee-forService Sector

($/month)

Average Medicare

Advantage Benchmark

($/month)

Ratio of Benchmark 

to FFS Cost

ALABAMA 109,975 672 774 1.15

ALASKA 53 699 820 1.17

ARIZONA 286,050 640 759 1.19

ARKANSAS 38,507 609 732 1.20

CALIFORNIA 1,440,451 733 840 1.15

COLORADO 162,802 659 773 1.17

CONNECTICUT 48,412 734 780 1.06

DELAWARE 2,744 675 738 1.09

DISTRICT OF COLUMBIA 6,255 756 882 1.17

FLORIDA 758,953 792 854 1.08

GEORGIA 99,283 631 753 1.19

HAWAII 67,020 530 746 1.41

IDAHO 39,103 596 735 1.23

ILLINOIS 133,797 687 767 1.12

INDIANA 81,814 614 743 1.21

IOWA 53,067 583 721 1.24

KANSAS 28,622 653 761 1.17

KENTUCKY 73,026 639 742 1.16

LOUISIANA 104,063 800 947 1.18

MAINE 4,314 572 727 1.27

MARYLAND 38,484 774 837 1.08

MASSACHUSETTS 167,810 728 813 1.12

MICHIGAN 215,264 679 761 1.12

MINNESOTA 206,578 666 750 1.13

MISSISSIPPI 30,520 662 778 1.17

MISSOURI 146,097 656 769 1.17

MONTANA 16,371 582 694 1.19

NEBRASKA 23,145 637 738 1.16

NEVADA 92,894 746 804 1.08

NEW HAMPSHIRE 3,104 630 754 1.20

NEW JERSEY 113,407 767 819 1.07

NEW MEXICO 58,829 530 748 1.41

NEW YORK 662,855 781 874 1.12

NORTH CAROLINA 172,255 601 750 1.25

NORTH DAKOTA 5,898 575 697 1.21

OHIO 305,970 651 761 1.17

OKLAHOMA 63,179 695 783 1.13

OREGON 206,518 582 749 1.29

PENNSYLVANIA 699,071 707 791 1.12

PUERTO RICO 339,907 328 569 1.74

RHODE ISLAND 60,732 634 765 1.21

SOUTH CAROLINA 57,849 630 748 1.19

SOUTH DAKOTA 6,203 566 694 1.23

TENNESSEE 159,666 640 755 1.18

TEXAS 368,282 753 907 1.21

UTAH 52,221 607 750 1.24

VERMONT 931 584 692 1.19

VIRGINIA 89,719 588 742 1.26

WASHINGTON 160,847 601 751 1.25

WEST VIRGINIA 36,630 639 744 1.16

WISCONSIN 159,192 580 730 1.26

WYOMING 2,847 631 710 1.13

U.S. Total 8,261,586 684 796 1.16
Sources:

The Medicare Advantage benchmark and local FFS cost information were obtained from the Centers

for Medicare & Medicaid Services (CMS) announcements of payment rates at

http://www.cms.hhs.gov/MedicareAdvtgSpecRateStats/AD.

Enrollment data were drawn from CMS's State-County-Contract file available at

http://www.cms.hhs.gov/MCRAdvPartDEnrolData/MMAESCC.

Note:

CMS does not report county-level enrollment if a plan has 10 or fewer enrollees in a county. That

results in partial undercounting of enrollment nationally. Other data from CMS show that total

enrollment in group plans in April 2007 is 8.5 million, or about 250,000 more than shown in this

table. 

1. Also includes the District of Columbia and Puerto Rico.

Definitions:

Total enrollment in group plans includes enrollment in local coordinated care plans, regional

preferred provider organizations, private fee-for-service plans, cost plans, PACE plans, health care

pre-payment plans, and certain demonstration programs.

Per capita cost in the fee-for-service sector is calculated from CMS's projection of FFS spending per

person in each county for 2007. Medicare Advantage benchmarks are the maximum amount that

Medicare would pay in each county in 2007 for an average beneficiary. The state-level averages

of those amounts are weighted by county-level enrollment in group plans. 

The ratio of the MA benchmark to FFS costs is the state average MA benchmark divided by the state

average FFS cost.