Payer Overview
MONTANA HLTH COOPERATIVE Market Analysis: Market Share and Coverage by State
Montana Hlth Cooperative is a regional health insurer focused on the Mountain West with concentrated membership and premium in a small set of states. Its scale supports local contracting influence but limited national leverage.
Payer Overview
Montana Hlth Cooperative is the #117 ranked US A&H payer by reported premium and participates across 3 states with a US premium of $442.28M, giving it a US market share of 0.03%. The organization reports an estimated total membership base of 116.6K and operates with 0 affiliated subsidiaries, positioning it as a regional player with concentrated state footprints rather than a national platform.
The Cooperative's largest presences are clustered in the Mountain West, and its operating scale — measured by premium and member counts — suggests focused contracting leverage in those states rather than broad national influence. This concentrated footprint supports targeted provider-network strategies in key states while offering limited scale for nationwide negotiations.
National Market Presence
State Market Table
| State | Market Share | Premium Written | Estimated Members |
|---|---|---|---|
| ID | 0.93% | $60.1M | 12.9K |
| MT | 7.11% | $219M | 56.5K |
| WY | 10.18% | $164M | 47.2K |
| National Total | — | $442M | 116.6K |
Montana Hlth Cooperative's premium and membership are heavily concentrated in the Mountain West. The Cooperative writes $219M in Montana, $164M in Wyoming, and $60.1M in Idaho, totaling $442M across the three states with 116.6K members. This geographic concentration creates strong local market influence in those states but limits national negotiating power.
For provider contracting, the payer's scale in Montana and Wyoming (combined $383M) means local networks and reimbursement arrangements in those states will be most impactful. National or multi-state provider groups should prioritize Montana and Wyoming when seeking leverage with this payer; Idaho is a smaller, secondary market for the Cooperative.
State-by-State Market Position
The Cooperative's strongest presence is in the West region, specifically the Mountain West where Wyoming and Montana represent its largest state footprints. Wyoming is the top state by market share at 10.18%, followed by Montana at 7.11%, while Idaho shows a modest presence at 0.93%. There is no meaningful presence in the Northeast, Southeast, Midwest, or Southwest regions based on the available state-level data.
This distribution means multi-state provider groups that operate across the Mountain West can achieve meaningful contracting impact with the Cooperative by focusing negotiations on Montana and Wyoming, where the payer's premium and membership are concentrated. Providers with minimal or no presence in these states will find limited incentive to prioritize contracting efforts with this payer given its regional concentration.
Estimated Member Demographics
| Age Band | Wyoming | Idaho | Montana | National Total |
|---|---|---|---|---|
| Under 6 | 2822 | 817 | 3095 | 6734 |
| 6–18 | 8336 | 2378 | 8268 | 18982 |
| 19–25 | 4107 | 1278 | 5339 | 10724 |
| 26–34 | 5419 | 1527 | 6578 | 13525 |
| 35–44 | 6897 | 1840 | 7877 | 16614 |
| 45–54 | 6000 | 1657 | 7218 | 14875 |
| 55–64 | 6599 | 1678 | 8319 | 16596 |
| 65–74 | 4232 | 1026 | 5764 | 11022 |
| 75+ | 2739 | 725 | 4052 | 7516 |
Nationally, the largest age bands are 6–18 (18,982 members), 35–44 (16,614 members), and 55–64 (16,596 members), indicating a strong presence among families with children and middle-aged adults. The under 6 and 75+ bands are smaller but still represent meaningful populations for pediatric and geriatric care.
Montana and Wyoming both show a balanced age distribution, with Montana having the highest total member count (56,511), followed by Wyoming (47,151) and Idaho (12,925). Idaho's member profile is slightly younger, with a higher proportion of members in the 6–18 and under 6 bands relative to its total. Providers should note these state-level nuances when planning care delivery and outreach.
Estimated Members by State
MONTANA HLTH COOPERATIVE's estimated member distribution is concentrated in Montana (56,511 members) and Wyoming (47,151 members), with a smaller but notable presence in Idaho (12,925 members). This geographic concentration aligns with the payer's premium volume and market share, as Montana and Wyoming are the states where the cooperative holds its strongest market positions.
While Montana has the highest member count, Wyoming is close behind, reflecting the payer's significant market share in both states. Idaho, despite a lower market share and premium volume, still contributes a meaningful member base. For providers, this means that contracting strategies and care delivery models should prioritize Montana and Wyoming, where the payer's influence and member volume are greatest. Idaho represents an opportunity for targeted outreach, especially for pediatric and family care providers given its younger member profile.