PrecaptureMedicaid Market IntelligenceDC MEDICAID MARKET
market exit
Elevance transition and continuity planning
Last verified 94 days ago · unknown because newest item is older than 21 days
MARKET_MOVEMENT
Verification tier 2Elevance leadership said the company mutually agreed with the District to exit DC Medicaid and expects additional targeted exits over 12–18 months where it does not see a path to sustainable performance.
Precapture analysis
Competitors should distinguish broad Medicaid commitment from state-level portfolio discipline and watch for continuity, rebid and replacement opportunities in marginal markets.
Parent, plan, and program come from the plan graph. Enrollment and share use the latest CMS reported count. Operations counts are CMS MCPAR. A dollar amount is not on this page.
| Parent | Plan | Programs | Latest CMS enrollment | Share | MCPAR operations |
|---|---|---|---|---|---|
| Independence Blue Cross | AmeriHealth Caritas District of Columbia | not reported | 106,839 (2024) | 48.5% calculated | 883 appeals resolved |
| AmeriHealth Caritas | AmeriHealth District of Columbia | not reported | 102,015 (2017) | 53.4% calculated | not reported |
| CareFirst | CareFirst Community Health Plan District of Columbia | not reported | 63,558 (2022) | 26.3% calculated | not reported |
| not reported | Health Services for Children with Special Needs | not reported | 5,006 (2022) | 100.0% calculated | not reported |
| not reported | Health Services for Children with Special Needs | not reported | 4,895 (2024) | 100.0% calculated | 144 appeals resolved |
| Parent | Plan | Programs | Latest CMS enrollment | Share | MCPAR operations |
|---|---|---|---|---|---|
| not reported | Edenbridge PACE | not reported | 61 (2024) | 100.0% calculated | not reported |
| Elevance | Amerigroup District of Columbia | not reported | 42,490 (2020) | 22.5% calculated | not reported |
| Elevance | Amerigroup District of Columbia | not reported | 56,651 (2024) | 25.7% calculated | 274 appeals resolved |
| not reported | Health Services for Children with Special Needs | not reported | 5,575 (2017) | 100.0% calculated | not reported |
| not reported | MedStar Family Choice | not reported | 55,694 (2017) | 29.1% calculated | not reported |
| not reported | MedStar Family Choice | not reported | 0 (2020) | 0.0% calculated | 237 appeals resolved |
| not reported | MedStar Family Choice -DC | not reported | 56,860 (2024) | 25.8% calculated | not reported |
| not reported | MedStar Family Choice-DC | not reported | 62,682 (2022) | 26.0% calculated | not reported |
| not reported | Medical Transportation Management, Inc. | not reported | 25,938 (2024) | 100.0% calculated | not reported |
| not reported | Health Services for Children with Special Needs | not reported | 5,056 (2019) | 100.0% calculated | not reported |
| not reported | Trusted Health Plan | not reported | 33,420 (2017) | 17.5% calculated | not reported |
| not reported | Trusted Health Plan | not reported | 30,081 (2019) | 15.9% calculated | not reported |
| UnitedHealth | UnitedHealthcare Community Plan of District of Columbia | not reported | 12,914 (2024) | 100.0% calculated | 650 appeals resolved |
| not reported | AmeriHealth District of Columbia | not reported | 96,622 (2016) | 55.1% calculated | not reported |
| not reported | Health Services for Children with Special Needs | not reported | 5,552 (2016) | 100.0% calculated | not reported |
| not reported | Medical Transportation Management Inc. | not reported | 53,970 (2016) | 100.0% calculated | not reported |
| not reported | Medstar Family Choice | not reported | 48,454 (2016) | 27.6% calculated | not reported |
| not reported | Trusted Health Plan | not reported | 30,314 (2016) | 17.3% calculated | not reported |
CMS reporting years in this file run from 2016 through 2024. Retrieved 2026-11-01. The latest reporting year is 2024, which is behind the retrieval date. Enrollment figures are the CMS cell for that reporting year. Share is calculated from CMS reported total enrollment for that state, program, and year. Precapture does not combine rows. A year missing from a trend was not reported. A plan and region with more than one CMS row in a year has no trend and no year-over-year change. The dataset says a reported 0 may not truly represent 0 when a state suppressed a small count. CMS reported.
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Health Services for Children with Special Needs | The HSC Foundation | The HSC Foundation | Statewide | not reported | not reported | not reported | not reported | 2018: 5,310 |
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Health Services for Children with Special Needs | Children's National | Children’s National | Statewide | CMS reported 4,895 (2024) | 100.0% | -198 (-3.9%) | 0.0 pts | 2020: 5,043; 2021: 4,846; 2022: 5,006; 2023: 5,093; 2024: 4,895 |
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Health Services for Children with Special Needs | The HSC Foundation | The HSC Foundation | Statewide | not reported | not reported | not reported | not reported | 2019: 5,056 |
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| AmeriHealth Caritas District of Columbia | AmeriHealth | AmeriHealth | Statewide | not reported | not reported | not reported | not reported | 2018: 110,610 |
| Amerigroup District of Columbia | Anthem Insurance Companies, Inc. | Elevance | Statewide | not reported | not reported | not reported | not reported | 2018: 43,522 |
| Trusted Health Plan | Trusted Health Plan, Inc. | Trusted Health Plan | Statewide | not reported | not reported | not reported | not reported | 2018: 30,674 |
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| UnitedHealthcare Community Plan of District of Columbia | UnitedHealthcare | UnitedHealth | Statewide | CMS reported 12,914 (2024) | 100.0% | -1,885 (-12.7%) | 0.0 pts | 2022: 12,637; 2023: 14,799; 2024: 12,914 |
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Health Services for Children with Special Needs | Health Services for Children with Special Needs | Health Services for Children with Special Needs | Statewide | not reported | not reported | not reported | not reported | 2016: 5,552; 2017: 5,575 |
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| AmeriHealth Caritas District of Columbia | AmeriHealth | AmeriHealth | Statewide | CMS reported 106,839 (2024) | 48.5% | -13,055 (-10.9%) | +0.2 pts | 2019: 116,573; 2020: 115,440; 2021: 106,387; 2022: 115,276; 2023: 119,894; 2024: 106,839 |
| AmeriHealth District of Columbia | AmeriHealth District of Columbia | AmeriHealth District of Columbia | Statewide | not reported | not reported | not reported | not reported | 2016: 96,622; 2017: 102,015 |
| Amerigroup District of Columbia | Amerigroup | Elevance | Statewide | CMS reported 56,651 (2024) | 25.7% | -7,490 (-11.7%) | -0.1 pts | 2019: 42,426; 2020: 42,490; 2023: 64,141; 2024: 56,651 |
| CareFirst Community Health Plan District of Columbia | CareFirst, Inc. | CareFirst | Statewide | not reported | not reported | not reported | not reported | 2020: 30,719; 2021: 60,610; 2022: 63,558 |
| MedStar Family Choice -DC | MedStar Health | MedStar Health | Statewide | CMS reported 56,860 (2024) | 25.8% | -7,330 (-11.4%) | -0.1 pts | 2023: 64,190; 2024: 56,860 |
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| MedStar Family Choice-DC | MedStar Health | MedStar Health | Statewide | not reported | not reported | not reported | not reported | 2021: 59,480; 2022: 62,682 |
| MedStar Family Choice | MedStar Health | MedStar Health | Statewide | not reported | not reported | not reported | not reported | 2017: 55,694; 2020: 0 |
| Medstar Family Choice | not reported | unmatched | Statewide | not reported | not reported | not reported | not reported | 2016: 48,454 |
| Trusted Health Plan | Trusted Health Plan, Inc. | Trusted Health Plan | Statewide | not reported | not reported | not reported | not reported | 2016: 30,314; 2017: 33,420; 2019: 30,081 |
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Medical Transportation Management, Inc. | Medical Transportation Management, Inc. | Medical Transportation Management, Inc. | Statewide | CMS reported 25,938 (2024) | 100.0% | -2,454 (-8.6%) | 0.0 pts | 2023: 28,392; 2024: 25,938 |
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Medical Transportation Management, Inc. | Medical Transportation Management, Inc. | Medical Transportation Management, Inc. | Statewide | not reported | not reported | not reported | not reported | 2018: 55,805 |
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Medical Transportation Management, Inc. | Medical Transportation Management, Inc. | Medical Transportation Management, Inc. | Statewide | not reported | not reported | not reported | not reported | 2022: 29,637 |
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Medical Transportation Management, Inc. | Medical Transportation Management, Inc. | Medical Transportation Management, Inc. | Statewide | not reported | not reported | not reported | not reported | 2019: 54,983; 2020: 53,900; 2021: 36,922 |
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Medical Transportation Management Inc. | not reported | unmatched | Statewide | not reported | not reported | not reported | not reported | 2016: 53,970 |
| Medical Transportation Management, Inc. | Medical Transportation Management, Inc. | Medical Transportation Management, Inc. | Statewide | not reported | not reported | not reported | not reported | 2017: 74,396 |
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Edenbridge PACE | Edenbridge | Edenbridge | Specific Zip Codes | not reported | not reported | not reported | not reported | 2023: 25 |
| Edenbridge PACE | Edenbridge | Edenbridge | Statewide | CMS reported 61 (2024) | 100.0% | not reported | not reported | 2024: 61 |
Counts, rates, dates, and status are the CMS MCPAR cells for that plan, program, and reporting year. The appeal rate is calculated from CMS reported appeals resolved in favor of the enrollee divided by CMS reported appeals resolved. It is not a CMS-published rate. A plan links when the name matches one enrollment plan in that same state and program. Unmatched is shown and is not guessed. A sanction amount is not on this page. Retrieved 2026-11-02. CMS MCPAR.
National plan operations · Federal compliance deadlines
| Plan | Parent | Program | Appeals resolved | In favor of enrollee | Appeal rate | Grievances resolved | Medicaid enrollment share | Managed care enrollment share |
|---|---|---|---|---|---|---|---|---|
| Health Services for Children with Special Needs | Children’s National | Child and Adolescent Supplemental Security Income Program | 64 | 44 | 68.8% calculated | 42 | 1.7% | 2.1% |
| AmeriHealth Caritas DC | AmeriHealth | DC Healthy Families Program | 616 | 114 | 18.5% calculated | 1,828 | 37.8% | 45% |
| Amerigroup DC | Elevance | DC Healthy Families Program | 212 | 44 | 20.8% calculated | 360 | 19.9% | 23.7% |
| MedStar Family Choice | MedStar Health | DC Healthy Families Program | 192 | 82 | 42.7% calculated | 1,321 | 19.8% | 23.6% |
| UnitedHealthcare of the MidAtlantic, Inc. | UnitedHealth | District Dual Choice | 367 | 297 | 80.9% calculated | 38 | 4.8% | 5.7% |
not reported.
Retrieved 2026-11-03. Sources and scores
No official early-procurement document has been retrieved for this state. This is not a finding that no signal exists. Early signals
No official Medicaid managed-care contract amendment has been retrieved for this state. This is not a finding that no amendment exists. Contract amendments
Indiana rows are official policy instruments. Other states show only Federal Register notices of hearings on SPA disapprovals, which are a narrow slice and not waiver or SPA coverage.
Federal Register notices of hearings on SPA disapprovals are read from the Federal Register JSON API. That covers no approved SPAs, waivers, or section 1115 demonstrations.
Coverage not_collected.
No official Medicaid managed-care policy instrument has been retrieved for this state. This is not a finding that no waiver, state plan amendment, or rule exists. Medicaid policy
Federal Register SPA disapproval hearing notices (2015 or later): 0
No official Medicaid plan financial filing has been retrieved for this state. This is not a finding that no filing exists, and it is not a zero. Plan financials. Coverage: not_collected.
Cited federal Medicaid managed care deadlines, with the Federal Register citation, the effective date, the compliance date, and the plan obligation.