Medical Membership
The number of people enrolled in an insurer's health plans at period end -- the customer base that generates premium revenue. It is reported by line of business (commercial, Medicare Advantage, Medicaid) and, crucially, on different bases: total medical membership counts everyone, while risk-based membership counts only members whose medical costs the insurer actually bears (as opposed to fee-based/administrative-services-only accounts, where the employer bears the cost and the insurer just processes claims). Growth in risk-based Medicare and Medicaid lives is where the premium -- and the risk -- concentrates, so read membership together with the medical loss ratio.
Related terms
Accounts Payable · Adjusted EBITDA · Adjusted EBITDA Ex-SBC · ADR · ARPU · Average Length Of Stay
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