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在开放招生之外切换医疗保险计划变得越来越常见,特别是在病情更严重的招生人群中,2015-22年
Grace Mackleby1, Angela Liu2, Erin Trish3
1Grace Mackleby (gracemcc@usc.edu), University of Southern California, Los Angeles, California.
Health affairs (Project Hope)
|February 2, 2026
概括
放松的医疗保险入学期允许更多的受益人全年更换计划. 然而,那些在开放入学期之外转换的人往往有更高的医疗保健需求,可能会增加Medicare Advantage计划的不良选择风险.
科学领域:
- 卫生政策 卫生政策
- 卫生经济学 卫生经济学
- 保险市场 保险市场 保险市场
背景情况:
- 医疗保险优势 (MA) 和传统的医疗保险计划使用入学期来防止不良选择.
- 最近的监管变化放宽了这些入学期,允许全年计划切换.
研究的目的:
- 分析放松入学期对受益者转换行为的影响.
- 评估受益人在标准入学期之外更换计划的健康风险概况.
主要方法:
- 对2015-2022年的行政数据进行分析.
- 不同招生期切换者之间的风险分数和住院率的比较.
主要成果:
- 越来越多的医疗保险优势计划注册者在标准开放注册期之外更换计划.
- 在替代招生期间转换的受益人表现出更高的风险分数和住院率.
- 切换到传统的医疗保险或更广泛的网络MA计划的人在切换前的风险得分更高.
结论:
- 灵活的入学时间可能会改善计划选择,但可能会加剧不良选择.
- 风险较高的受益人可能会不成比例地利用灵活的招生,可能会压迫计划的财务.
- 现有的不利选择减轻政策可能不足以更灵活的入学规则.
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