Table 2. Contract-Level Disenrollment Over Time by Contract Characteristicsa.
| Contract type | Contract-years, No. | Disenrollment, mean (SD), % | |
|---|---|---|---|
| 1 y | 5 y | ||
| Plan typeb | |||
| PPO | 2702 | 20.7 (23.9) | 74.7 (30.5) |
| HMO | 1806 | 15.7 (18.0) | 54.2 (34.5) |
| Premium, $b,c | |||
| 0 | 498 | 19.8 (16.9) | 66.3 (32.8) |
| 0-30 | 1492 | 19.2 (21.0) | 66.1 (32.9) |
| >30 | 1902 | 18.1 (24.6) | 56.6 (35.8) |
| Vertical integration statusd | |||
| Integrated | 3273 | 16.7 (17.6) | 64.3 (33.5) |
| Not integrated | 680 | 12.5 (17.5) | 40.0 (33.0) |
| Dual enrollment, tertilee | |||
| 1 (0%-8%) | 1466 | 19.0 (24.8) | 57.2 (35.4) |
| 2 (9%-33%) | 1473 | 20.3 (22.1) | 66.4 (33.8) |
| 3 (>33%) | 1247 | 15.2 (17.4) | 61.3 (33.5) |
| Race and ethnicity, tertilee | |||
| American Indian/Alaska Native | |||
| 1 (0%-0.05%) | 1148 | 18.7 (23.3) | 60.1 (34.6) |
| 2 (0.06%-2.2%) | 1639 | 19.0 (22.7) | 62.7 (34.3) |
| 3 (>2.2%) | 1399 | 17.2 (19.9) | 62.3 (34.7) |
| Asian | |||
| 1 (0%-1.0%) | 1268 | 18.6 (23.0) | 60.9 (35.5) |
| 2 (1.1%-2.0%) | 1486 | 19.4 (23.6) | 63.0 (34.7) |
| 3 (>2.0%) | 1432 | 18.3 (19.9) | 62.7 (33.2) |
| Black | |||
| 1 (0%-4%) | 1438 | 16.9 (22.6) | 53.9 (34.5) |
| 2 (5%-16%) | 1492 | 17.8 (20.6) | 63.1 (34.2) |
| 3 (>16%) | 1256 | 20.6 (22.8) | 70.7 (32.7) |
| Hispanic | |||
| 1 (0%-2%) | 1334 | 17.8 (23.8) | 57.8 (35.5) |
| 2 (3%-10%) | 1426 | 19.3 (23.5) | 63.6 (35.1) |
| 3 (>10%) | 1426 | 17.9 (18.2) | 64.6 (32.5) |
| White | |||
| 1 (0%-57%) | 1333 | 18.7 (19.1) | 69.0 (30.3) |
| 2 (58%-86%) | 1434 | 20.0 (23.9) | 65.4 (35.7) |
| 3 (>86%) | 1419 | 16.3 (22.3) | 53.0 (34.6) |
| Contract enrollmente | |||
| Small (0-3000) | 808 | 17.9 (18.1) | 67.3 (33.5) |
| Medium (3001-15 000) | 1682 | 18.3 (21.1) | 66.4 (34.1) |
| Large (>15 000) | 1688 | 18.5 (24.2) | 53.5 (34.0) |
Abbreviations: HMO, health maintenance organization; PPO, preferred provider organization.
a
Disenrollment was defined as a beneficiary voluntarily leaving their contract for either traditional Medicare or another Medicare Advantage contract and then aggregated to the contract level.
b
Derived from publicly available plan benefit files.
c
While premium is a plan-level characteristic, we assigned a contract-level premium as a weighted average of all plan premiums within that contract.
d
Integration status was determined using a database of contracts that were vertically integrated with health systems.
e
Derived from the Master Beneficiary Summary File and aggregated to the contract-year level.