The Medicare Advantage market is ever-evolving, with Chronic Condition Special Needs Plans (C-SNPs) emerging as a notable growth area. While Dual-Eligible Special Needs Plans (D-SNPs) saw a significant slowdown in 2024, C-SNPs experienced a remarkable surge. In particular, Medicare Advantage plans without a corresponding Medicaid arm offering coordinated-only D-SNPs need a comprehensive SNP strategy in place to offset future D-SNP integration requirements. Here's why C-SNPs are gaining traction and why health plans should consider investing in them.
1. The Rise of C-SNPs:
The growth trajectory of C-SNPs in 2024 has been nothing short of impressive. Enrollment spiked by 61% from December 2023 to December 2024, a substantial increase from the 28% growth seen in 2023. In contrast, the D-SNP market's growth decelerated to just 6% in 2024, down from over 24% in previous years. This stark contrast highlights the shifting focus towards C-SNPs.
The latest data from the 2025 Annual Election Period (AEP) reinforces this trend:
C-SNP enrollment increased by 25% during AEP.
D-SNP enrollment remained steady, growing by 0.8%.
Overall Medicare Advantage (MA) enrollment grew by 1.33%.
Full-pay MA plans saw 0.8% growth over the AEP.
The number of organizations offering C-SNPs increased from 37 in 2024 to 52 in 2025—a 40% increase.
The number of C-SNP plan benefit packages (PBPs) also tripled from 2024 to 2025.
The number of counties where C-SNPs are offered increased by 15%, and they are now available in over 75% of counties where MA plans are offered.
“Considering that over 8% of members received a termination notice, the fact that overall MA membership growth remained positive is stunning. This further underscores how C-SNP is becoming a strategic focus for organizations. The dramatic 40% increase in the number of C-SNP organizations and the tripling of plan offerings highlight the growing investment in this segment,” highlighted Roshan Desai, VP of Product and Financial Strategy.
2. Dominant States, Untapped Potential, and High-Growth Areas:
C-SNP enrollment is concentrated in large Medicare Advantage (MA) states like Florida, Texas, California, Georgia, and Illinois, reflecting their high individual MA enrollment rates. Additionally, several states stood out in 2024 for their impressive C-SNP growth percentages, including Alabama, Tennessee, North Carolina, Michigan, Utah, Kentucky, Colorado, and Indiana. However, there are notable gaps in states with significant MA populations but minimal C-SNP enrollment, such as Pennsylvania, Ohio, and New York. These states represent untapped market potential for health plans looking to expand their footprint.
3. Penetration Rates and Market Potential:
Nationwide, the C-SNP penetration rate remains relatively low at 3%. However, states like Arkansas and Mississippi have reached penetration rates of 11%, demonstrating the high potential for growth. C-SNPs can be designed to enroll members with common chronic conditions, allowing MA plans to manage current and prospective members more closely and effectively. This underscores the significant opportunities for health plans to invest in and develop their C-SNP offerings.
4. Leading Carriers and Market Dynamics:
The C-SNP market is dominated by major players like UnitedHealth Group and Humana, both of which saw significant growth in 2024. UnitedHealth expanded its market presence across multiple states, contributing to all growth in Alabama and Tennessee. However, smaller regional carriers like Alignment, GuideWell Mutual, and Zing also experienced substantial percentage growth, indicating a competitive and dynamic market.
5. Future Outlook and Strategic Shifts:
The C-SNP market remains relatively small and immature but is poised for continued expansion. With new state-level entrants, evolving carrier strategies, changes to the Dual Eligible Special Needs Plan (D-SNP) Special Enrollment Period (SEP), and the push by CMS and individual states towards integrated D-SNPs, the focus on C-SNPs is likely to intensify in 2025. Health plans must stay agile and proactive to capture this growth.
How Rebellis Group Can Help:
Rebellis Group, a managed care expert consultancy, is well-equipped to assist health plans in evaluating, building, and optimizing their SNP strategy, including C-SNPs. Our services include:
Comprehensive market analysis to identify growth opportunities and untapped markets.
Customized strategic planning to align with evolving market dynamics.
Financial modeling to illustrate potential revenue and margin gains from a C-SNP.
Operational support to streamline plan implementation and optimize performance.
Ongoing monitoring and adjustments to ensure sustained growth and compliance.
Investing in C-SNPs presents a significant opportunity for health plans to enhance their offerings and meet the needs of individuals with chronic conditions. C-SNPs allow health plans to enroll all year long (via the chronic condition SEP), target and convert non-SNP lives, and be a positive margin leader for a health plan if run properly. By partnering with Rebellis Group, health plans can navigate this complex landscape and achieve success in the burgeoning C-SNP market.