What happens when Medicare Advantage contracts are terminated?

Around 1 in 5 Medicare Advantage beneficiaries switch to traditional Medicare when their plans shut down, a study published Aug. 20 in JAMA Network Open found. 

The study examined data from 2016 to 2018. During these years, CMS was prohibited from terminating MA contracts for poor performance, so contract terminations were likely initiated by the insurer, the study's authors wrote. 

Among beneficiaries whose contracts were terminated, 20.1% switched to traditional Medicare. Among those who remained in MA, most selected plans with higher star ratings. The majority of enrollees (66.5%) who switched to a new plan paid the same or lower premiums. 

A higher proportion of dual-eligible beneficiaries (32.7%) switched to traditional Medicare when their MA plans shut down. Black enrollees and enrollees with prior use of a hospital, nursing home or home healthcare were also more likely to switch to traditional Medicare than other groups. 

The study's findings "highlight the need to examine consequences of contract terminations and subsequent insurance destinations on access to care and health outcomes, especially among those with marginalized race and ethnicity, those who are dual-eligible, and beneficiaries with higher healthcare needs," the study's authors wrote. 

The study was conducted by researchers at the Brown University School of Public Health in Providence, R.I. 

Read more here. 

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