Medicare Advantage disenrollment jumps with each complex diagnosis: Study

Each complex condition further drives Medicare Advantage disenrollment, according to research published Aug. 21 in JAMA Health Forum. 

Researchers from Baltimore-based Johns Hopkins University reviewed a cohort of more than 1 million MA beneficiaries to determine transitions to traditional Medicare or other MA plans.

Here are six notes from the research:

1. The development of any new complex condition was linked to a 3.3 percentage-point increase in MA disenrollment, with 2.8 and 0.5 percentage-point increases in switching to traditional Medicare or another MA plan, respectively.

2. The number of new conditions correlated to heightened MA disenrollment. Beneficiaries with one, two and three new complex conditions saw percentage-point increases in MA disenrollment of 1.4, 5.1 and 8.7, respectively. For beneficiaries with four or more new complex conditions, that increase in MA disenrollment was 12.8 percentage points.

3. By 2020, 37.3% of people with at least four new complex conditions who had been enrolled in MA in 2019 had disenrolled from their plan. That figure was 30.9%, 25.6%, 21% and 17.6% for people with three, two, one and zero new complex conditions, respectively.  

4. However, looking at those who stayed enrolled in MA in 2020, disenrollment rates dropped in 2021. 

5. Among reviewed individual conditions, Alzheimer’s disease and related disorders were linked to the greatest disenrollment at 8.6 percentage points.

6. Beneficiaries who had new complex conditions and were in states with Medigap community rating and guaranteed issue policies were 1.5 percentage points more likely to disenroll to traditional Medicare compared to those with new conditions in states lacking these policies.

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