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Health Aff (Millwood). 2018 Jan;37(1):70-77. doi: 10.1377/hlthaff.2017.0974.

Medicare Advantage Ratings And Voluntary Disenrollment Among Patients With End-Stage Renal Disease.

Author information

1
Qijuan Li ( qijuan_li@brown.edu ) is an adjunct professor of health services research at the Brown University School of Public Health, in Providence, Rhode Island, and director of innovation analytics at SCIO Health Analytics, in West Hartford, Connecticut.
2
Amal N. Trivedi is an associate professor in the Department of Health Services, Policy, and Practice, Brown University School of Public Health.
3
Omar Galarraga is an associate professor in the Department of Health Services, Policy, and Practice, Brown University School of Public Health.
4
Michael E. Chernew is the Leonard D. Schaeffer Professor of Health Care Policy in the Department of Health Care Policy, Harvard Medical School, in Boston, Massachusetts.
5
Daniel E. Weiner is an associate professor of medicine at Tufts Medical Center, in Boston.
6
Vincent Mor is a professor in the Department of Health Services, Policy, and Practice at the Brown University School of Public Health and a health scientist at the Providence Veterans Affairs Medical Center, in Rhode Island.

Abstract

Populations with intensive health care needs and high care costs may be attracted to insurance plans that have high quality ratings, but patients may be likely to disenroll from a plan if their care needs are not met. We assessed the association between publicly reported Medicare Advantage plan star ratings and voluntary disenrollment of incident dialysis patients in the following year over the period 2007-13. We found that Medicare Advantage (MA) plans with lower star ratings had significantly higher rates of disenrollment by incident dialysis patients in the following year. Compared to MA plans with 4.0 or more stars, adjusted disenrollment rates were 3.9 percentage points higher for plans with 3.5 stars, 5.0 percentage points higher for those with 3.0 stars, and 12.1 percentage points higher for those with 2.5 or fewer stars. These findings suggest that low plan quality may lead to increased expenditures, as this high-cost population generally must shift from Medicare Advantage to traditional Medicare upon disenrollment.

KEYWORDS:

Medicare Advantage plan star rating; end stage renal disease; voluntary disenrollment

PMID:
29309223
PMCID:
PMC6021124
DOI:
10.1377/hlthaff.2017.0974
[Indexed for MEDLINE]
Free PMC Article

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