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Rates of Disenrollment From Medicare Advantage Plans Are Higher for Racial/Ethnic Minority Beneficiaries

Bibliographic Data

ID9102666
AuthorsSteven C Martino (0000-0002-1514-4133, RAND Corporation, Pittsburgh, PA, corresponding author), Megan Mathews (0000-0002-8813-6847, RAND Corporation, Santa Monica), Cheryl L Damberg (0000-0001-8169-9420, RAND Corporation, Santa Monica), Joshua S Mallett (Social Policy Research Associates, Oakland, CA), Joshua Mallett (Social Policy Research Associates (United States)), Nate Orr (RAND Corporation, Santa Monica), Judy H Ng (National Committee for Quality Assurance, Washington, DC), Judy Ng (National Committee for Quality Assurance), Denis Agniel (0000-0003-1483-2724, RAND Corporation, Santa Monica), Loida Tamayo (Centers for Medicare & Medicaid Services, Baltimore, MD), Marc N Elliott (0000-0002-7147-5535, RAND Corporation, Santa Monica)
Year2021
Volume59
Issue9
Pages778-784
Publication date2021-09-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000001574
PMID34054025
OpenAlexW3165314422
LanguageEN
Citations received3
References cited26

BACKGROUND: Each year, about 10% of Medicare Advantage (MA) enrollees voluntarily switch to another MA contract, while another 2% voluntarily switch from MA to fee-for-service Medicare. Voluntary disenrollment from MA plans is related to beneficiaries' negative experiences with their plan, disrupts the continuity of care, and conflicts with goals to reduce Medicare costs. Little is known about racial/ethnic disparities in voluntary disenrollment from MA plans. OBJECTIVE: The objective of this study was to investigate differences in rates of voluntary disenrollment from MA plans by race/ethnicity. SUBJECTS: A total of 116,770,319 beneficiaries enrolled in 736 MA plans in 2015. METHODS: Differences in rates of disenrollment across racial/ethnic groups [Asian or Pacific Islander (API), Black, Hispanic, and White] were summarized using 4 types of logistic regression models: adjusted and unadjusted models estimating overall differences and adjusted and unadjusted models estimating within-plan differences. Unadjusted overall models included only racial/ethnic group probabilities as predictors. Adjusted overall models added age, sex, dual eligibility, disability, and state of residence as control variables. Between-plan differences were estimated by subtracting within-plan differences from overall differences. RESULTS: Adjusted rates of disenrollment were significantly (P<0.001) higher for Hispanic (+1.2 percentage points), Black (+1.2 percentage points), and API beneficiaries (+2.4 percentage points) than for Whites. Within states, all 3 racial/ethnic minority groups tended to be concentrated in higher disenrollment plans. Within plans, API beneficiaries voluntarily disenrolled considerably more often than otherwise similar White beneficiaries. CONCLUSION: These findings suggest the need to address cost, information, and other factors that may create barriers to racial/ethnic minority beneficiaries' enrollment in plans with lower overall disenrollment rates

Actuarial science · Business · Economic growth · Economics · Ethnic group · Health care · Medicare Advantage · MEDLINE · Political science · Sociology · Demography · Healthcare Policy and Management · Medication Adherence and Compliance · Medicine · Primary Care and Health Outcomes · Gerontology

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  • Predictors of Voluntary Disenrollment From Medicare Managed Care

    Judy H Ng, Judy Ng et al.•Medical Care•2007

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Unique citing works3
Citations per year1
Citation span2023 - 2025 (3)
Citation velocityrecent
Highly citedNo
Citation typesNeutral: 2
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