转换医疗保险:在医疗保险优势中招生增长的模式,2006-22
Lanlan Xu1, W Pete Welch2, Steven Sheingold3
1Lanlan Xu (lanlan.xu@hhs.gov), Department of Health and Human Services, Washington, D.C.
Health affairs (Project Hope)
|September 5, 2023
概括
医疗保险优势 (MA) 注册人数正在激增,大多数新注册人从传统医疗保险转向医疗保险. 从传统医疗保险 (Medicare) 转换为AM有三倍,而从AM转换为传统医疗保险 (Medicare) 的比例有所下降,特别是在2019年以来.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 卫生经济学 卫生经济学
- 公共卫生政策 公共卫生政策
背景情况:
- 医疗保险优势 (MA) 在过去20年中经历了大幅增长,预计将继续扩大.
- 了解招生动态和受益者转换模式对于评估不断变化的医疗保健环境至关重要.
研究的目的:
- 分析医疗保险优势入学的最新趋势,重点关注MA和传统的服务费医疗保险之间的切换模式.
- 确定影响受益者在MA和传统医疗保险之间过渡的人口和健康相关因素.
主要方法:
- 利用2006年至2022年的最新和详细数据来检查入学来源和转换行为.
- 对受益者特征进行分析,包括种族,双重资格,残疾状况,年龄和健康状况,以确定与转换相关的因素.
主要成果:
- 从传统的费用服务医疗保险转换为MA在2006年至2022年期间增加了三倍多.
- 从MA回到传统医疗保险的转换减少,自2019年以来观察到加速变化.
- 从传统医疗保险转换的MA新入学者的比例从2011年的61%增加到2022年的80%.
- 特定的人口群体 (黑人,双重资格,残疾人) 在两个方向上都显示出更高的转换率.
- 年轻,健康的受益者更有可能转向MA,但不太可能转回.
结论:
- 这一趋势表明,医疗保险优惠计划的入学率正在显著且加速转变.
- 受益特征在行为转换中发挥作用,突出不同群体之间的潜在差异或偏好.
- 在1月的开放招生期间,转换的集中表明其在MA市场动态中的重要性.
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