Project 2x250 · Federal spending, from government actuals

Who collects America's Medicare dollars

In 2023, Medicare paid private insurers $557 billion in Medicare Advantage capitation and Part D net payments. Three companies took 61% of it.

$557BTo private insurers (MA + Part D)

$339BTop 3 (UnitedHealth, Humana, CVS)

$176BUnitedHealth alone, 32% of the total

What's not shown: Medicaid managed care routes a comparable sum to these same insurers, but the public data commingles federal and state dollars at the plan level, so it can't be cleanly attributed here. It goes dark. The bars above are only the audit-grade Medicare chains.

Every parent company, sortable

CY2023, $ billions. Click a column to sort. Part D net = direct subsidy + reinsurance + LIPSA + risk corridors + LICS.
#	Parent company	MA capitation	Part D net	Total	Share
1	UnitedHealth Group	146.5	29.4	175.9	31.57%
2	Humana	84.4	15.8	100.2	17.98%
3	CVS Health (Aetna)	44.4	18.2	62.6	11.23%
4	Elevance Health (Anthem)	30.8	4.8	35.6	6.39%
5	Centene	19.8	13.5	33.2	5.96%
6	Kaiser Permanente	24.4	1.3	25.7	4.61%
7	Cigna	8.8	7.4	16.2	2.90%
8	Blue Cross Blue Shield of Michigan	8.9	0.4	9.4	1.68%
9	Highmark	5.3	0.6	6.0	1.07%
10	Healthfirst	4.1	1.5	5.6	1.01%
11	SCAN	4.8	0.3	5.1	0.91%
12	GuideWell (Florida Blue)	3.7	0.4	4.1	0.73%
13	UPMC	2.8	0.4	3.2	0.58%
14	MHH Healthcare	2.6	0.3	2.9	0.52%
15	Corewell Health	2.6	0.2	2.9	0.51%
16	BlueCross BlueShield of Tennessee	2.3	0.3	2.6	0.47%
17	Health Care Service	2.0	0.5	2.4	0.43%
18	California Physicians' Service	2.1	0.3	2.4	0.43%
19	Molina Healthcare, Inc.,	1.8	0.5	2.3	0.41%
20	Independence Health Group	1.8	0.2	2.1	0.37%
21	Devoted Health	1.9	0.2	2.1	0.37%
22	Lifetime Healthcare	1.8	0.2	2.0	0.36%
23	Bright Health Group	1.7	0.2	1.9	0.34%
24	Point32Health	1.7	0.1	1.9	0.33%
25	EmblemHealth	1.6	0.2	1.9	0.33%
26	Alignment Healthcare USA	1.7	0.1	1.8	0.32%
27	Group 1001	0.0	1.8	1.8	0.31%
28	Aware Integrated	1.6	0.1	1.6	0.29%
29	Cambia Health Solutions	1.5	0.1	1.6	0.29%
30	Geisinger Health	1.3	0.2	1.5	0.27%
31	Clover Health Holdings	1.2	0.2	1.4	0.25%
32	UCare Minnesota	1.3	0.1	1.4	0.24%
33	Blue Cross and Blue Shield of North Carolina	1.2	0.1	1.3	0.24%
34	BlueCross BlueShield of Alabama	1.2	0.1	1.3	0.23%
35	Rite Aid	0.0	1.3	1.3	0.23%
36	Henry Ford Health System	1.1	0.1	1.1	0.20%
37	Triton Health Systems, L.L.C.	0.8	0.2	1.0	0.18%
38	Independent Health Association	0.9	0.1	1.0	0.17%
39	Lumeris Group Holdings	0.9	0.0	0.9	0.17%
40	Blue Cross & Blue Shield of Rhode Island	0.9	0.1	0.9	0.17%
41	Leon Health Holdings	0.8	0.1	0.9	0.16%
42	Blue Cross and Blue Shield of Massachusetts	0.8	0.1	0.9	0.16%
43	Providence St Joseph Health	0.8	0.1	0.8	0.15%
44	Network Health	0.8	0.1	0.8	0.14%
45	Blue Cross of Idaho Health Service	0.6	0.1	0.7	0.13%
46	Presbyterian Healthcare Services	0.6	0.1	0.7	0.13%
47	MVP Health Care	0.7	0.1	0.7	0.13%
48	Martin's Point Health Care	0.7	0.0	0.7	0.13%
49	Marshfield Clinic Health System	0.7	0.0	0.7	0.13%
50	Sentara Health Care (SHC)	0.6	0.1	0.7	0.12%
51	Capital District Physicians' Health Plan	0.6	0.1	0.7	0.12%
52	Medica Holding Company	0.5	0.1	0.6	0.11%
53	Louisiana Health Service & Indemnity Company	0.5	0.1	0.6	0.11%
54	Trinity Health	0.6	0.0	0.6	0.10%
55	PacificSource	0.5	0.1	0.6	0.10%
56	Intermountain Health Care	0.5	0.0	0.6	0.10%
57	NJ Collaborative Care	0.5	0.0	0.5	0.10%
58	The Carle Foundation	0.5	0.0	0.5	0.09%
59	MEDICAL MUTUAL OF OHIO	0.5	0.0	0.5	0.09%
60	Health First Shared Services	0.5	0.0	0.5	0.09%
61	CAPITAL BLUE CROSS	0.5	0.0	0.5	0.09%
62	Hawaii Medical Service Association	0.4	0.0	0.5	0.09%
63	Banner Health	0.4	0.1	0.5	0.08%
64	HealthPartners	0.4	0.0	0.5	0.08%
65	St Francis Health System & St John Health System	0.4	0.0	0.5	0.08%
66	Baylor Scott & White Holdings	0.4	0.0	0.4	0.08%
67	Universal Health Services	0.4	0.0	0.4	0.07%
68	Premera	0.4	0.0	0.4	0.07%
69	Mercy Care	0.3	0.1	0.4	0.07%
70	Blue Cross and Blue Shield of Kansas City	0.3	0.0	0.4	0.07%
71	Summa Health	0.3	0.0	0.3	0.06%
72	University of Wisconsin Hospitals and Clincs Autho	0.3	0.0	0.3	0.06%
73	Blue Cross Blue Shield of Arizona	0.3	0.0	0.3	0.06%
74	Thomas Jefferson University	0.2	0.1	0.3	0.06%
75	Elderplan	0.3	0.1	0.3	0.06%
76	USAble Mutual Insurance Company	0.3	0.0	0.3	0.05%
77	Community Health Plan of Washington	0.2	0.1	0.3	0.05%
78	BlueCross BlueShield of South Carolina (BCBSSC)	0.2	0.1	0.3	0.05%
79	Visiting Nurse Service of New York	0.2	0.1	0.2	0.05%
80	Renown Health	0.2	0.0	0.2	0.04%
81	ATRIO Health Plans	0.2	0.0	0.2	0.04%
82	Allina Health and Aetna Insurance Holding Company	0.2	0.0	0.2	0.04%
83	Ultimate Healthcare Holdings	0.2	0.0	0.2	0.04%
84	Elevance Health, Inc. & BCBSMA & BCBSRI & BCBSVT	0.0	0.2	0.2	0.04%
85	Johns Hopkins Healthcare	0.2	0.0	0.2	0.04%
86	New York City Health and Hospitals	0.1	0.1	0.2	0.04%
87	Clever Care Health Plan	0.2	0.0	0.2	0.04%
88	Promedica Health System	0.2	0.0	0.2	0.04%
89	Indiana University Health	0.2	0.0	0.2	0.04%
90	DOCTORS HEALTHCARE PLANS, INC.	0.2	0.0	0.2	0.03%
91	Aultman Health Foundation	0.2	0.0	0.2	0.03%
92	HTA Holdings	0.2	0.0	0.2	0.03%
93	Fallon Community Health Plan	0.2	0.0	0.2	0.03%
94	The Health Plan of West Virginia	0.1	0.0	0.2	0.03%
95	BCBS MN, MT, NE, ND, WY, Wellmark IA and SD	0.0	0.2	0.2	0.03%
96	BayCare Health System	0.1	0.0	0.1	0.03%
97	Sharp Healthcare	0.1	0.0	0.1	0.02%
98	Texas Health Resources	0.1	0.0	0.1	0.02%
99	Mutual of Omaha Insurance Company	0.0	0.1	0.1	0.02%
100	Baystate Health	0.1	0.0	0.1	0.02%
101	CareFirst	0.1	0.0	0.1	0.02%
102	Zing Health Consolidator, Inc	0.1	0.0	0.1	0.02%
103	Alterwood Health	0.1	0.0	0.1	0.02%
104	Denver Health and Hospital Authority	0.1	0.0	0.1	0.02%
105	Imperial Health Plan of California	0.1	0.0	0.1	0.02%
106	Associated Care Ventures	0.1	0.0	0.1	0.02%
107	Village Care of New York	0.1	0.0	0.1	0.02%
108	Chinese Hospital Association	0.1	0.0	0.1	0.02%
109	UNICO Services	0.1	0.0	0.1	0.02%
110	HealthPartners UnityPoint Health	0.1	0.0	0.1	0.02%
111	Montage Health	0.1	0.0	0.1	0.02%
112	University of Michigan Health	0.1	0.0	0.1	0.02%
113	Samaritan Health Services	0.1	0.0	0.1	0.02%
114	Moda Partners	0.1	0.0	0.1	0.02%
115	SNP Holdings	0.1	0.0	0.1	0.02%
116	Mitchell Family Office	0.1	0.0	0.1	0.02%
117	AllCare Health	0.1	0.0	0.1	0.01%
118	Blue Cross Blue Shield of Nebraska	0.1	0.0	0.1	0.01%
119	Memorial Hermann Health System	0.1	0.0	0.1	0.01%
120	Commonwealth of PA Pub Schools Retirement System	0.0	0.1	0.1	0.01%
121	Centers Plan for Healthy Living	0.1	0.0	0.1	0.01%
122	Astiva Group	0.1	0.0	0.1	0.01%
123	Sanford Health	0.1	0.0	0.1	0.01%
124	CareSource	0.0	0.0	0.1	0.01%
125	Athena Healthcare Holdings	0.1	0.0	0.1	0.01%
126	Commonwealth Care Alliance	0.1	0.0	0.1	0.01%
127	Select Founders	0.0	0.0	0.1	0.01%
128	CHRISTUS Health	0.1	0.0	0.1	0.01%
129	Blue Cross Blue Shield of Kansas	0.0	0.0	0.1	0.01%
130	Hamaspik of Rockland County	0.0	0.0	0.1	0.01%
131	Troy Holdings	0.0	0.0	0.1	0.01%
132	Horizon Mutual Holdings, Inc	0.0	0.0	0.0	0.01%
133	Mary Washington Healthcare	0.0	0.0	0.0	0.01%
134	Independent Living Systems	0.0	0.0	0.0	0.01%
135	Liberty Healthcare Insurance	0.0	0.0	0.0	0.01%
136	Ochsner Clinic Foundation	0.0	0.0	0.0	0.01%
137	Rifkin Managed Care Holding	0.0	0.0	0.0	0.01%
138	Western Health Advantage	0.0	0.0	0.0	0.01%
139	Kansas Superior Select	0.0	0.0	0.0	0.00%
140	Marquis Companies I	0.0	0.0	0.0	0.00%
141	Innovative Long Term Care Management	0.0	0.0	0.0	0.00%
142	Perennial Consortium	0.0	0.0	0.0	0.00%
143	McLaren Health Care	0.0	0.0	0.0	0.00%
144	Oscar Health	0.0	0.0	0.0	0.00%
145	University of Utah	0.0	0.0	0.0	0.00%
146	Gold Kidney Health Plan	0.0	0.0	0.0	0.00%
147	ParkerCare New York	0.0	0.0	0.0	0.00%
148	SIHO Holding	0.0	0.0	0.0	0.00%
149	BMC Health System	0.0	0.0	0.0	0.00%
150	Tennessee Rural Health Improvement Association	0.0	0.0	0.0	0.00%
151	Central Mass Health Holding	0.0	0.0	0.0	0.00%
152	MedImpact Holdings	0.0	0.0	0.0	0.00%
153	RiverSpring Living Holding Corp.	0.0	0.0	0.0	0.00%
154	Aspirus	0.0	0.0	0.0	0.00%
155	Avian Health Holdings	0.0	0.0	0.0	0.00%
156	Mass General Brigham Incorporated	0.0	0.0	0.0	0.00%
157	Educators Mutual Insurance Association	0.0	0.0	0.0	0.00%

Source. CMS Part C/Part D Medical Loss Ratio (MLR) Data Release File, CY2023, Line 1.2 “MA Plan Payments” (the realized federal capitation) plus Part D net subsidies. Parent rollup via the CMS CPSC Contract Info crosswalk (Dec 2023); 100% of MA dollars matched to a named parent. Reconciliation: MA total $452.3B = 96.9% of the 2024 Medicare Trustees Report Part C figure ($466.7B); Part D net $105.0B = 90.3% of FY2023 CFDA 93.770. “Collects” means the entity the federal government paid; what insurers pay downstream providers is not public. Full method in the post.