Lives data updates and trends
Trusted insights with Managed Market Surveyor (MMS) & Pharmacy Benefit Evaluator
Build your market access strategy using accurate U.S. managed care enrollment data
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Pharmacy Benefit Evaluator (PBE)
& Managed Market Surveyor (MMS)
The dynamic and rapidly changing U.S. payer landscape makes it crucial for pharma, biotech, and med tech companies to have the most up-to-date and accurate enrollment and pharmacy benefit data. Our trusted and rigorously validated enrolled lives and pharmacy benefit management data delivers a comprehensive dataset curated through a survey conducted twice a year of payers and government agencies by our expert analyst team.
Here are the key highlights from the latest January 2025 data release:
Public health insurance exchange grows:
Enrollment as of January 2025 had grown by at least 2.2 million, or about 11%, over the prior six months and by at least 2.7 million, or about 14%, over the previous year.
Commercial fully insured declines:
Excluding exchange enrollment, health insurers’ commercial membership as of January 2025 had declined over the previous six months due to a drop of more than 2 million in fully insured lives, although self-insured enrollment increased.
Medicare enrollment trend disrupted:
Medicare fee-for-service enrollment grew by 462,000 and outpaced Medicare Advantage growth of 284,000 from July 2024 to January 2025. That contrasts with a yearslong trend of steadily declining FFS enrollment countered by strong MA enrollment growth.
Medicaid contraction slows:
The trend of declining enrollment continued but slowed significantly from its previously precipitous pace. As of January 2025, Medicaid enrollment decreased by about 537,000, or less than 1%, over the prior six months.
Each data purchase comes with the support and insights of our subject matter experts
- Our analyst team goes above and beyond to identify key trends and insights from the latest data. With a deep understanding of the market, they provide analysis with insights you can rely on.
- We want you to get the most out of your purchase. That’s why we provide complimentary training sessions to help you understand the data and its applications. Our subject matter experts will be available to guide you through the insights and help you make informed decisions.
How our enrollment and PBM data informs customer strategies and decision making
- Inform your payer contracting strategy. With accurate and up-to-date information on payer market share, you can make strategic decisions to optimize your market access.
- Stay ahead of the competition. Analyze the shifts and trends in enrollment to identify opportunities and grow the accessibility of your therapies or maintain your market position.
- Navigate benefit design using influence. Understand the influencers of benefit design for key accounts and markets and navigate benefit design strategies more effectively.
Don’t miss out on the opportunity to equip yourself with essential enrollment data and insights. Complete the form to start leveraging the power of MMS Enrolled Lives data and trends reports to drive your market access strategy forward. Also consider purchasing Pharmacy Benefit Evaluator (PBE), which complements MMS and provides pharmacy benefit manager to health plan affiliations data with details on relationship and contract design showing control of formulary decision making and access.
The MMS Enrolled Lives and PBE data release occurs twice each year: The July data point is released in December followed by the January data point released in June. Stay tuned for future updates.
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