Medicare Switching: Patterns Of Enrollment Growth In Medicare Advantage, 2006-22.

Area of Science:

• Health Services Research
• Health Economics
• Public Health Policy

Background:

• Medicare Advantage (MA) has experienced substantial growth over the last 20 years and is projected to continue expanding.
• Understanding enrollment dynamics and beneficiary switching patterns is crucial for assessing the evolving healthcare landscape.

Purpose of the Study:

• To analyze recent trends in Medicare Advantage enrollment, focusing on switching patterns between MA and traditional fee-for-service Medicare.
• To identify demographic and health-related factors influencing beneficiary transitions between MA and traditional Medicare.

Main Methods:

• Utilized recent and detailed data from 2006 to 2022 to examine enrollment sources and switching behaviors.
• Conducted analyses on beneficiary characteristics, including race, dual eligibility, disability status, age, and health status, to determine factors associated with switching.

Main Results:

• Switching from traditional fee-for-service Medicare to MA more than tripled between 2006 and 2022.
• Switching from MA back to traditional Medicare decreased, with accelerating changes observed since 2019.
• The proportion of new MA enrollees who switched from traditional Medicare increased from 61% in 2011 to 80% in 2022.
• Specific demographic groups (Black, dual-eligible, disabled) showed higher switching odds in both directions.
• Younger, healthier beneficiaries were more likely to switch to MA but less likely to switch back.

Conclusions:

• The trend indicates a significant and accelerating shift towards Medicare Advantage enrollment.
• Beneficiary characteristics play a role in switching behaviors, highlighting potential disparities or preferences among different groups.
• The concentration of switching during the January open enrollment period suggests its importance in MA market dynamics.