Seniors are given the opportunity to switch Medicare Advantage plans annually, but some evidence suggests that committing to multi-year contracts could lead to better health outcomes.
It's also an idea recently pitched by Robert Andrews, CEO of the Health Transformation Alliance and former U.S. Congressman from New Jersey, on the Becker's Healthcare podcast on Sept. 2. The HTA represents the healthcare interests of some of the largest self-insured employers in the country.
"If I could make one change in the Medicare Advantage system, I would make it possible for MA plans to offer multi-year contracts to sign up a consumer for three or four years instead of one," Mr. Andrews said. "The window, if you broaden it, becomes much more attractive for investment in things like smoking cessation, or weight control, or better behavioral health — things that will all lead to better outcomes. I think we should power Medicare Advantage with multi-year agreements, lengthen the ROI window for providers and make it more at-risk for better outcomes. It's not going to make the provider and insurer disconnect go away, but I think it begins to alleviate that problem."
Around 16% of MA enrollees switch plans after one year of enrollment, an October 2022 study in the American Journal of Managed Care found. Nearly half switched insurers by their fifth year.
"Turnover in [Medicare Advantage] may lead to inferior health outcomes through disjointed care and decreased investment in improved care delivery. Future research could help assess the extent to which turnover affects the care that MA enrollees receive," the study's authors wrote.
"You don't rehab the kitchen of an apartment that you're renting, you rehab the kitchen of a condo that you own," Mr. Andrews said. "If we took away some of that churn risk from MA plan sponsors, I think they would make better investments in health outcomes. Now, I understand when dealing with a fee-for-service provider system there's some skepticism with that, but I think altering the economic incentives for MA carriers would be a positive thing for the system."