title: Health plan disenrollment in a choice-based Medicaid managed care program.
abstract: Consumer decisions to switch health plans have implications for quality of care and risk selection. We examine factors related to time to disenrollment in a Medicaid managed care program where beneficiaries face a menu of plans and can change plans every month. Several findings have direct policy relevance. Families and individuals who make active choices upon entering the program are at substantially lower risk of disenrollment than those who are auto-assigned. Interactions between enrollee ethnicity and provider language proficiency suggest that enrollee satisfaction depends on the cultural competence of providers. Differential disenrollment by risk status results in adverse retention for certain types of plans.
authors.affiliation: Graduate School of Management, University of California, Irvine, Irvine, CA 92612, USA. tcbuchmu@uci.edu
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Buchmueller
authors.forename: Todd
authors.initials: T
authors.lastname: Gilmer
authors.forename: Katherine
authors.initials: K
authors.lastname: Harris
mesh_terms: D000328:Adult; D002140:California; D002648:Child; D002755:Choice Behavior; D003258:Consumer Behavior; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D005006:Ethnicity / Q000706:statistics & numerical data; D005191:Family Characteristics; D005260:Female; D006801:Humans; D015273:Insurance Selection Bias; D008297:Male; D008329:Managed Care Programs / Q000706:statistics & numerical data*; D008484:Medicaid / Q000458:organization & administration* / Q000706:statistics & numerical data; D008875:Middle Aged; D017059:Models, Econometric; D016016:Proportional Hazards Models; D012306:Risk; D016019:Survival Analysis; D014481:United States