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延长急性后期使用者退出医疗保险优势计划期限的影响

The Effect of Extending the Window to Disenroll From Medicare Advantage Among Post-Acute Users.

作者信息

Achola Emma M, Trivedi Amal N, Kim Daeho, Meyers David J, Varma Hiren, Keohane Laura M

机构信息

Department of Health Policy, Vanderbilt University School of Medicine, Nashville, TN, USA.

Brown University, Providence, RI, USA.

出版信息

Med Care Res Rev. 2025 Apr;82(2):165-172. doi: 10.1177/10775587241313092. Epub 2025 Jan 23.

Abstract

Post-acute care users in Medicare Advantage (MA) plans may seek coverage changes if facing issues with plan benefits. In 2019, the Centers for Medicare and Medicaid Services extended the deadline to disenroll from an MA plan from February 14 to March 31 and, for the first time, permitted beneficiaries to switch to a different MA plan instead of traditional Medicare. Using 2016-2019 Medicare administrative data, we implemented a difference-in-differences approach to evaluate the impact of this policy on disenrollment from a plan within 1 month of initiating skilled nursing facility or home health services. When MA disenrollment rules became more flexible, overall rates of exiting MA plans did not change. Switching to a different MA plan increased after the policy change, but this outcome was so rare that this increase did not affect overall rates of exiting MA plans.

摘要

医疗保险优势(MA)计划中的急性后期护理用户如果在计划福利方面遇到问题,可能会寻求保险范围的变更。2019年,医疗保险和医疗补助服务中心将从MA计划中退出的截止日期从2月14日延长至3月31日,并且首次允许受益人转而选择不同的MA计划,而非传统医疗保险。我们利用2016 - 2019年医疗保险管理数据,采用双重差分法来评估这项政策对在启动熟练护理设施或家庭健康服务后1个月内退出计划的影响。当MA退出规则变得更加灵活时,退出MA计划的总体比率并未改变。政策变更后,转而选择不同MA计划的情况有所增加,但这种情况极为罕见,以至于这一增加并未影响退出MA计划的总体比率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d505/11872052/68e911d2244b/10.1177_10775587241313092-fig1.jpg

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