Medicare Advantage Plan Switching: Exception or Norm?
Overview
Jacobson, Gretchen A., Patricia Neuman, and Anthony Damico, “At Least Half Of New Medicare Advantage Enrollees Had Switched From Traditional Medicare During 2006-11,” Health Affairs (Milwood), 34(1): 148-55, January 2015.
Riley, Gerald F., “Impact of Continued Biased Disenrollment from the Medicare Advantage Program to Fee-for-Service” Medicare & Medicaid Research Review 2(4): E1-E16, 2012. Available at: https://www.cms.gov/mmrr/Downloads/MMRR2012_002_04_A08.pdf.
McWilliams, J. Michael, John Hsu, and Joseph P. Newhouse. “New Risk-Adjustment System Was Associated with Reduced Favorable Selection in Medicare Advantage.” Health Affairs (Milwood) 31(12): 2630-2640, December 2012. Available at: http://content.healthaffairs.org/content/31/12/2630.full.pdf+html.
Newhouse, Joseph P., Mary Price, Jie Huang, J. Michael McWilliams, and John Hsu. “Steps to Reduce Favorable Risk Selection in Medicare Advantage Largely Succeeded, Boding Well for Health Insurance Exchanges.” Health Affairs (Milwood), 31(12): 2618-2628, December 2012. Available at: http://content.healthaffairs.org/content/31/12/2618.full.pdf+html.
Issue Brief
A prior analysis found a higher rate of switching between Medicare Advantage and traditional Medicare. The rate is somewhat lower in this analysis because it excludes beneficiaries enrolled in Medicare Advantage plans that did not offer prescription drug coverage, employer group waiver plans, and Special Needs Plans (n=4.78 million beneficiaries in 2013). In total, 4.78 million beneficiaries who would have been included in the other analysis were excluded from this analysis for 2013. For the other analysis, see Jacobson, Gretchen A., Patricia Neuman, and Anthony Damico, “At Least Half Of New Medicare Advantage Enrollees Had Switched From Traditional Medicare During 2006-11,” Health Affairs (Milwood), 34(1): 148-55, January 2015.
For more information about the change in plans available between 2009 and 2010, see Gold, Marsha, Dawn Phelps, Gretchen Jacobson, and Tricia Neuman. “Medicare Advantage 2010 Data Spotlight: Plan Enrollment Patterns and Trends.” Kaiser Family Foundation, June 2010. Available at: https://www.kff.org/medicare/issue-brief/medicare-advantage-2010-data-spotlight-plan-enrollment/.
Hoadley, Jack, Elizabeth Hargrave, Laura Summer, Juliette Cubanski, and Tricia Neuman. “To Switch or Not to Switch: Are Medicare Beneficiaries Switching Drug Plans To Save Money?” Kaiser Family Foundation, October 2013. Available at: https://www.kff.org/medicare/issue-brief/to-switch-or-not-to-switch-are-medicare-beneficiaries-switching-drug-plans-to-save-money/.
Office of the Assistant Secretary for Planning and Evaluation. “Health Insurance Marketplace Premiums After Shopping, Switching and Premium Tax Credits, 2015-2016.” ASPE Issue Brief, April 2016. Available at: https://aspe.hhs.gov/sites/default/files/pdf/198636/MarketplaceRate.pdf.
The rates of plan switching in the Federal Employees Health Benefits (FEHB) Program was 12 percent between 2000 and 2001. See Atherly, Adam, Curtis Florence, and Kenneth E. Thorpe. “Health Plan Switching Among Members of the Federal Employees Health Benefits Program.” Inquiry, 42: 255-265, Fall 2005. Available at: http://inq.sagepub.com/content/42/3/255.full.pdf. Approximately 6 percent of CalPERS members switched health plans between 2014 and 2015, which was higher than previous years. See CalPERS Pension and Health Benefits Committee. “Health Open Enrollment Results.” February 18, 2015. Available at: https://www.calpers.ca.gov/docs/board-agendas/201502/pension/item-10.pdf.
Office of the Assistant Secretary for Planning and Evaluation. “Health Insurance Marketplace Premiums After Shopping, Switching and Premium Tax Credits, 2015-2016.” ASPE Issue Brief, April 2016. Available at: https://aspe.hhs.gov/sites/default/files/pdf/198636/MarketplaceRate.pdf.
Levine, David M., Stuart R. Lipsitz, and Jeffrey A. Linder. “Trends in Seniors’ Use of Digital Health Technology in the United States, 2011-2014.” JAMA, August 2016. Available at: http://jama.jamanetwork.com/article.aspx?articleid=2540389.
Jacobson, Gretchen A., Patricia Neuman, and Anthony Damico, “At Least Half Of New Medicare Advantage Enrollees Had Switched From Traditional Medicare During 2006-11,” Health Affairs (Milwood), 34(1): 148-55, January 2015.
While most SNP enrollees are dual eligibles, not all dually eligible beneficiaries who are enrolled in Medicare Advantage plans are in SNPs: about 1.2 million dual eligibles were enrolled in SNPs and about 1.1 million dual eligibles were enrolled in other Medicare Advantage plans in 2013.
Notably, a larger share of enrollees in non-metropolitan areas (8 percent) than metropolitan areas (4 percent) were forced to switch plans (involuntary switching) because their plan exited the market between 2013 and 2014. This difference in involuntary switching rates was consistent across all years of this study.
For another example and discussion of price elasticity in plan choice, see Buchmueller, Thomas C. and Paul J. Feldstein. “The Effect of Price on Switching Among Health Plans.” Journal of Health Economics, 16(2): 231-247, April 1997.
Jacobson, Gretchen, Christina Swoope, Michael Perry, and Mary C. Slosar. “How are Seniors Choosing and Changing Health Insurance Plans?” Kaiser Family Foundation, May 2014. Available at: https://www.kff.org/medicare/report/how-are-seniors-choosing-and-changing-health-insurance-plans/.