Open Enrollment Period and Rapid Disenrollment Study

The Medicare Advantage OEP gives individuals enrolled in a Medicare Advantage plan an opportunity make a one-time switch to either another Medicare Advantage plan or to Original Medicare. Switching is generally associated with some form of consumer dissatisfaction. And it triggers something health plans refer to as Rapid Disenrollment – a phenomenon where a health plan member leaves the plan shortly after the new year (and new benefits) begin.

The Medicare Open Enrollment Period Study is an add-on to the Medicare Shopping and Switching Study. It examines post-AEP switching and correlated factors, including onboarding experiences.

Agents Play a Big Role in OEP Switching

n 2021, approximately one-third of OEP switchers received help from an agent, compared to 5% of non-switchers. Lower premiums, better dental, and more supplemental benefit flexibility are some of the top reasons OEP switchers landed in their new plans.

Problems stemming from uncertainty about coverage for medications and procedures, sometimes increased by poor communication, frequently motivated seniors to continue shopping during the OEP.

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CAHPS AND QRS: A Better Way to Explain Your CAHPS/QRS Scores

In this article we discuss the challenges of using a health plan’s raw quality survey data to diagnose why quality ratings may be low and what can be done about it. We’ve developed a new methodology for diagnostic studies that increases the explanatory power of our research.

Background: Regulatory surveys such as Medicare’s Consumer Assessment of Healthcare Providers and Systems (CAHPS), and the Affordable Care Act’s Quality Rating System (QRS), are designed to deliver a set of metrics for health plan comparisons. Comparisons are used by health plans to identify areas for improvement and they are used by CMS to determine rewards for high performing health plans.

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