ND MEDICAID MARKET
North Dakota
monitoring
No current verified market signal.
Last verified: unavailable
Last verified: unavailable · no state-specific item
No current verified signal
Precapture is monitoring this market. No state-specific public intelligence item is currently published.
Plans in this market
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.
Plans in this market 20
| Parent | Plan | Programs | Latest CMS enrollment | Share | MCPAR operations |
|---|---|---|---|---|---|
| Blue Cross Blue Shield of North Dakota | ND Medicaid Expansion | not reported | 24,356 (2024) | 100.0% calculated | not reported |
| not reported | North Dakota Medicaid Expansion | not reported | 36,680 (2022) | 100.0% calculated | not reported |
| not reported | Primary Care Case Management | not reported | 72,232 (2023) | 100.0% calculated | not reported |
| not reported | Primary Care Case Management (PCCM) | not reported | 67,874 (2022) | 100.0% calculated | not reported |
| not reported | Program of All-Inclusive Care for the Elderly | not reported | 185 (2022) | 100.0% calculated | not reported |
show all 20
| Parent | Plan | Programs | Latest CMS enrollment | Share | MCPAR operations |
|---|---|---|---|---|---|
| not reported | ND Medicaid Expansion MCO | not reported | 33,639 (2021) | 100.0% calculated | not reported |
| not reported | Primary Care Case Management (PCCM) | not reported | 52,339 (2021) | 100.0% calculated | not reported |
| not reported | Program of All-Inclusive Care for the Elderly | not reported | 190 (2024) | 100.0% calculated | not reported |
| not reported | Northland PACE Senior Care Services | not reported | 176 (2020) | 100.0% calculated | not reported |
| not reported | Program of All-inclusive Care for the Elderly | not reported | 167 (2021) | 100.0% calculated | not reported |
| not reported | ND Medicaid Expansion MCO | not reported | 21,497 (2020) | 100.0% calculated | not reported |
| not reported | Health Management | not reported | 0 (2018) | not reported | not reported |
| not reported | Health Management | not reported | 223 (2016) | 100.0% calculated | not reported |
| not reported | Multiple Primary Care Providers | not reported | 48,264 (2016) | 100.0% calculated | not reported |
| not reported | Multiple Primary Care Providers | not reported | 48,957 (2018) | 100.0% calculated | not reported |
| not reported | Multiple Primary Care Providers | not reported | 52,810 (2020) | 100.0% calculated | not reported |
| not reported | Multiple Primary Care Providers (PCCM) | not reported | 49,399 (2017) | 100.0% calculated | not reported |
| not reported | ND Medicaid Expansion - Sanford Health Plan | not reported | 21,232 (2016) | 100.0% calculated | not reported |
| not reported | PACE | not reported | 115 (2016) | 100.0% calculated | not reported |
| not reported | PACE | not reported | 157 (2017) | 100.0% calculated | not reported |
CMS reported enrollment
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.
Health Management Program (Other Prepaid Health Plan (PHP) (limited benefits))
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Health Management | US Care Management | US Care Management | Statewide | not reported | not reported | not reported | not reported | 2016: 223; 2017: 177; 2018: 0 |
Multiple Primary Care Providers (PCCM) (Primary Care Case Management (PCCM))
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Multiple Primary Care Providers | Multiple Primary Care Providers | unmatched | Statewide | not reported | not reported | not reported | not reported | 2020: 52,810 |
Multiple Primary Care Providers (Primary Care Case Management (PCCM))
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Primary Care Case Management (PCCM) | North Dakota Medicaid | North Dakota Medicaid | Statewide | not reported | not reported | not reported | not reported | 2021: 52,339 |
ND Medicaid Expansion (Comprehensive MCO)
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| ND Medicaid Expansion | Blue Cross Blue Shield of North Dakota | Blue Cross Blue Shield of North Dakota | Statewide | CMS reported 24,356 (2024) | 100.0% | -12,324 (-33.6%) | 0.0 pts | 2023: 36,680; 2024: 24,356 |
North Dakota Medicaid Expansion (Comprehensive MCO)
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| ND Medicaid Expansion - Sanford Health Plan | not reported | unmatched | Statewide | not reported | not reported | not reported | not reported | 2016: 21,232 |
| ND Medicaid Expansion MCO | ND Medicaid | ND Medicaid | Statewide | not reported | not reported | not reported | not reported | 2017: 20,515; 2018: 19,515; 2019: 19,692; 2020: 21,497; 2021: 33,639 |
| North Dakota Medicaid Expansion | ND Health & Human Services | ND Health & Human Services | Statewide | not reported | not reported | not reported | not reported | 2022: 36,680 |
PACE (Program of All-inclusive Care for the Elderly (PACE))
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Northland PACE Senior Care Services | Northland PACE Senior Care Services | Northland PACE Senior Care Services | Bismarck: 58501, 58502, 58503; Burlington: 58722; Cass: 58047, 58078, 58102, 58103, 58104, 58105; Dickinson: 58601, 58602; Gladstone: 58630; Lincoln: 58504; Mandan: 58554; Menoken: 58558; Minot: 58701, 58702, 58703; Richardton: 58652; South Heart: 58655; Surrey: 58785; Taylor: 58656 | not reported | not reported | not reported | not reported | 2020: 176 |
| Northland PACE Senior Care Services | Northland PACE Senior Care Services | Northland PACE Senior Care Services | Ward: 58701, 58702, 58703, 58722, 58785; Burleigh: 58501, 58502, 58503, 58504, 58558; Morton: 58554; Stark: 58601, 58602, 58630, 58652, 58655, 58656 | not reported | not reported | not reported | not reported | 2019: 180 |
| Northland PACE Senior Care Services | Northland PACE Senior Care Services | Northland PACE Senior Care Services | Zip codes: 58501, 58502, 58503 (Bismarck), 58504 (Lincoln), 58554 (Mandan), 58558 (Menoken), 58601, 58602 (Dickinson), 58652 (Richardton), 58655 (South Heart), 58656 (Taylor), 58701, 58702, 58703, 58722, 58785 (Minot) | not reported | not reported | not reported | not reported | 2018: 181 |
| PACE | PACE | unmatched | 58501, 58502, 58503 (Bismarck), 58504 (Lincoln), 58554 (Mandan), 58558 (Menoken), 58601, 58602 (Dickinson), 58652 (Richardton), 58655 (South Heart), 58656 (Taylor), 58701, 58702, 58703, 58722, 58785 (Minot) | not reported | not reported | not reported | not reported | 2016: 115; 2017: 157 |
PCCM (Primary Care Case Management (PCCM))
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Multiple Primary Care Providers (PCCM) | Multiple Primary Care Providers (PCCM) | unmatched | Statewide | not reported | not reported | not reported | not reported | 2017: 49,399 |
| Multiple Primary Care Providers | Multiple Primary Care Providers | unmatched | Statewide | not reported | not reported | not reported | not reported | 2016: 48,264; 2018: 48,957; 2019: 45,939 |
Primary Care Case Management (PCCM)
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Primary Care Case Management | ND Health & Human Services | ND Health & Human Services | Statewide | not reported | not reported | not reported | not reported | 2023: 72,232 |
Primary Care Case Management Program (PCCM)
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Primary Care Case Management (PCCM) | ND Health & Human Services | ND Health & Human Services | Statewide | not reported | not reported | not reported | not reported | 2022: 67,874 |
Program of All-Inclusive Care for the Elderly (PACE)
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Program of All-Inclusive Care for the Elderly | ND Health & Human Services | ND Health & Human Services | zip codes | not reported | not reported | not reported | not reported | 2022: 185 |
| Program of All-Inclusive Care for the Elderly | Northland PACE | Northland PACE | Specific Zip Codes | CMS reported 190 (2024) | 100.0% | 0 (0.0%) | 0.0 pts | 2023: 190; 2024: 190 |
Program of All-Inclusive Care for the Elderly (Program of All-inclusive Care for the Elderly (PACE))
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Program of All-inclusive Care for the Elderly | Program of All-inclusive Care for the Elderly | Program of All-inclusive Care for the Elderly | Burleigh- 58501, 58502, 58503, 58504, 58558 Cass- 58047, 58078, 58102, 58103, 58104, 58105 Stark- 58601, 58602, 58630, 58652, 58655, 58656 Morton- 58554 Ward- 58701, 58702, 58703, 58722, 58785 | not reported | not reported | not reported | not reported | 2021: 167 |
Plan operations (CMS MCPAR)
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
Appeals, grievances, and enrollment share (2024)
| Plan | Parent | Program | Appeals resolved | In favor of enrollee | Appeal rate | Grievances resolved | Medicaid enrollment share | Managed care enrollment share |
|---|---|---|---|---|---|---|---|---|
| Blue Cross Blue Shield North Dakota | unmatched | Medicaid Expansion June 2025 Submission | 1,124 | 415 | 36.9% calculated | 23 | 24% | 100% |
Sanctions (2024)
| Plan | Parent | Topic | Date | Corrective action plan | Remediation status |
|---|---|---|---|---|---|
| Blue Cross Blue Shield North Dakota | unmatched | Reporting | 2024-08-07 | Yes | Yes, remediated |
Award history
not published by state. No official award, score, or protest was retrieved for this state on 2026-11-03. Award history
Early procurement signals
No official early-procurement document has been retrieved for this state. This is not a finding that no signal exists. Early signals
Contract amendments
No official Medicaid managed-care contract amendment has been retrieved for this state. This is not a finding that no amendment exists. Contract amendments
Medicaid policy
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
Plan financials
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.
Federal compliance deadlines
Cited federal Medicaid managed care deadlines, with the Federal Register citation, the effective date, the compliance date, and the plan obligation.