Harris-Kojetin L, Booske B, Lynch J, Ritter CS, Bender R, Rudolph B; Academy for Health Services Research and Health Policy. Meeting.
Abstr Acad Health Serv Res Health Policy Meet. 2002; 19: 7.
Health and Aging Research Program, RTI International, 1615 M Street, N.W., Suite 740, Washington, DC 20036; Tel: (202)728-2064; Fax: (202)738-2095; E-mail: lauren@rti.org
RESEARCH OBJECTIVE: Determine whether beneficiaries with different health status and socio-economic characteristics choose to leave Medicare+Choice (M+C) plans for different reasons. STUDY DESIGN: The 2000 Medicare CAHPS Disenrollment Reasons survey allowed beneficiaries to indicate all reasons they had for leaving a plan among over 30 pre-printed reasons. We developed eight groupings among similar types of reasons: five groupings address problems with care or service received from the plan while three groupings address concerns about plan costs. Respondents could cite multiple reasons. The outcome variables are the percentage of respondents whose responses fall into each of the eight reasons groupings. The independent variables are self-perceived health status and health compared to the previous year, race, ethnicity, months in plan, aged versus young-disabled Medicare status, education, and sex. Our preliminary analysis examined the bivariate relationships between each subgroup variable and outcome variable using chi-square to identify significant results. We report differences of at least 10 percentage points. POPULATION STUDIED: The nationally representative data set consists of 37,338 Medicare beneficiary respondents who voluntarily disenrolled from approximately 285 M+C organizations during 2000. PRINCIPAL FINDINGS: Initial results indicate that the most frequently cited reasons for leaving a plan were increases in premiums and/or co-payments and problems getting to see particular doctors. However, between one-quarter to one-third of respondents cited problems with plan information, problems getting care, problems getting particular needs met, or problems getting or paying for prescription medicines as reasons for leaving a plan. Those in poorer health, those whose health had worsened in the past year, and those with a disability (younger than age 65) were significantly more likely than others to cite problems with information from the plan, problems getting care, problems getting particular needs met, and problems getting or paying for prescription medicines as reasons for leaving. Blacks, Hispanics, and those who left the plan within four months of enrollment were more likely than others to cite problems with plan information as a reason for leaving. Those who left their plan within four months of enrolling were also more likely than those who stayed longer to cite problems getting care as a reason for leaving. These results are preliminary and should not be cited. Final results, available in March 2002, will be the basis for the presentation. CONCLUSIONS: The reasons that voluntary disenrollees give for leaving their M+C plans can provide a valuable perspective on M+C plan member disenrollment. Preliminary findings suggest that beneficiaries in poorer or worsening health and younger beneficiaries with disabilities - members of vulnerable Medicare populations - may be leaving M+C plans because they have special needs that are not being met within their plans. IMPLICATIONS FOR POLICY, DELIVERY OR PRACTICE: These findings can enhance the ability of CMS to monitor the quality of care and relative performance of M+C organizations. PRIMARY FUNDING SOURCE: Foundations
Publication Types:
Keywords:
- Health Services Needs and Demand
- Humans
- Medicare
- Medicare Part C
- Prescriptions, Drug
- economics
- hsrmtgs
Other ID:
UI: 102273880
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