Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island, USA.
Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Med Care Res Rev. 2021 Dec;78(6):693-702. doi: 10.1177/1077558720944284. Epub 2020 Aug 1.
Approximately 34% of all Medicare beneficiaries were enrolled in a Medicare Advantage (MA) plan in 2019. Quantitative evidence suggests that MA beneficiaries have low rates of switching plans, but that beneficiaries who are hospitalized or use postacute nursing home care are disproportionately more likely to exit their plan. This research sought to explore how MA enrollees choose plans and the factors involved in their decision to keep their current plan or switch plans. We conducted 25 semistructured interviews focusing on expectations and experiences preenrollment and postenrollment among MA beneficiaries. Overall, the beneficiaries interviewed reported being highly satisfied with their plans. After selecting a plan, there was little incentive to revisit their choice since they viewed their plan as "good enough." Confusion, health status, cost and benefits also contributed to many seniors keeping or switching their plans. These seniors were reluctant to switch plans unless they experienced a major health event.
2019 年,约有 34%的医疗保险受益人参加了医疗保险优势(MA)计划。定量证据表明,MA 受益人的计划转换率较低,但住院或使用急性后期疗养院护理的受益人更有可能退出其计划。这项研究旨在探讨 MA 参保人如何选择计划,以及影响他们决定保留当前计划或转换计划的因素。我们进行了 25 次半结构化访谈,重点关注 MA 受益人的入保前和入保后的期望和经验。总体而言,接受采访的受益人均对其计划表示非常满意。选择计划后,由于他们认为自己的计划“足够好”,因此很少有动力重新考虑自己的选择。困惑、健康状况、成本和收益也是许多老年人保留或更换计划的原因。这些老年人除非经历重大健康事件,否则不愿意更换计划。