Medicare Advantage Ratings And Voluntary Disenrollment Among Patients With End-Stage Renal Disease
Medicare Advantage Ratings And Voluntary Disenrollment Among Patients With End-Stage Renal Disease
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DOI：
10.1377/hlthaff.2017.0974
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发表时间：
2018-01-01
期刊：
影响因子：
9.7
通讯作者：
Mor, Vincent
中科院分区：
文献类型：
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作者：
Li, Qijuan;Trivedi, Amal N.;Mor, Vincent
具有密集医疗保健需求和高护理成本的人群可能会被具有高质量评级的保险计划所吸引，但如果他们的护理需求得不到满足，患者可能会退出计划。我们评估了2007年至2013年期间公开报道的医疗保险优势计划星星评级与事件透析患者自愿退出之间的关联。我们发现，医疗保险优势（MA）计划与较低的星星评级有显着较高的比率退出事件透析患者在第二年。与4.0星或以上的MA计划相比，3.5星计划的调整后退学率高出3.9个百分点，3.0星计划高出5.0个百分点，2.5星或以下计划高出12.1个百分点。这些研究结果表明，低计划质量可能会导致支出增加，因为这种高成本的人口通常必须从医疗保险优势转移到传统的医疗保险后，取消登记。
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.