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Disenrollment from a prepaid group plan. A multivariate analysis.

V D Hennelly, S B Boxerman

    Medical Care
    |December 1, 1983
    PubMed
    Summary
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    High annual disenrollment from prepaid group practices (PGPs) is complex. Key factors influencing voluntary and mandatory disenrollment include demographics, satisfaction, and available alternatives, posing challenges for PGP managers.

    Area of Science:

    • Health Services Research
    • Health Economics
    • Medical Care Management

    Background:

    • High annual disenrollment rates from prepaid group practices (PGPs) present significant management challenges.
    • Previous studies have primarily offered descriptive accounts of PGP disenrollment phenomena.
    • A need exists for advanced analytical methods to understand the complex factors driving disenrollment.

    Purpose of the Study:

    • To identify and analyze the significant correlates of voluntary and mandatory disenrollment from PGPs.
    • To differentiate between member populations based on enrollment status (continuous, voluntary disenrollment, mandatory disenrollment).
    • To provide insights for PGP managers to address disenrollment challenges.

    Main Methods:

    • Utilized multivariate techniques, specifically discriminant analysis and logistic regression, for in-depth analysis.

    Related Experiment Videos

  • Employed data from two surveys conducted by the Medical Care Group of St. Louis (MCGSL).
  • Classified 2,402 families into continuous enrollees, voluntary disenrollees, and mandatory disenrollees for comparative analysis.

    • Main Results:

    • Identified significant sociodemographic differences (subscriber age, race, education, occupation, family size, income) among the three groups.
    • Found that satisfaction levels with the PGP and the availability of alternative health insurance options are significant discriminators.
    • Demonstrated that nonplan family members and alternative health coverage independently influence disenrollment decisions.

    Conclusions:

    • Voluntary and mandatory disenrollment behaviors are more complex than previously understood.
    • Disenrollment is influenced by a combination of individual characteristics, satisfaction, and market alternatives.
    • PGP managers face multifaceted challenges in controlling disenrollment rates due to these complex factors.