Risk Factors for Early Disenrollment From Colorado's Affordable Care Act Marketplace.
Background: Midyear disenrollment from Marketplace coverage may have detrimental effects on continuity of care and risk pool stability of individual health insurance markets.Objective: The main objective of this study was to assess associations between insurance plan characteristics, individual and...
| Publicado en: | Medical Care Vol. 57; no. 1; pp. 49 - 54 |
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| Autores principales: | , , , , |
| Formato: | research Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
Jan2019
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=136244088&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 136244088 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00257079 21B jtl: Medical Care issn: 00257079 maglogo: N pubinfo: dt: Jan2019 vid: 57 iid: 1 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 136244088 136244088 NLM30531597 136244088 10.1097/MLR.0000000000001020 NLM30531597 136244088 ppf: 49 ppct: 5 formats: tig: atl: Risk Factors for Early Disenrollment From Colorado's Affordable Care Act Marketplace. aug: au: Gordon, Sarah H. Sommers, Benjamin D. Wilson, Ira B. Galarraga, Omar Trivedi, Amal N. affil: Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, RI sug: subj: Health Insurance Exchanges Statistics and Numerical Data Medically Uninsured Statistics and Numerical Data Patient Protection and Affordable Care Act Insurance Coverage Economics Insurance, Health Economics Health Care Costs Insurance Economics Adult United States Male Health Benefit Plans, Employee Economics Female Human Insurance Colorado Risk Factors Validation Studies Comparative Studies Evaluation Research Multicenter Studies Adult: 19-44 years Male Female ab: Background: Midyear disenrollment from Marketplace coverage may have detrimental effects on continuity of care and risk pool stability of individual health insurance markets.Objective: The main objective of this study was to assess associations between insurance plan characteristics, individual and area-level demographics, and disenrollment from Marketplace coverage.Data: All payer claims data from individual market enrollees, 2014-2016.Study Design: We estimated Cox proportional hazards models to assess the relationship between plan actuarial value and Marketplace enrollment. The primary outcome was disenrollment from Marketplace coverage before the end of the year. We also calculated the proportion of enrollees who transitioned to other coverage after leaving the Marketplace, and identified demographic and area-level factors associated with early disenrollment. Finally, we compared monthly utilization rates between those who disenrolled early and those who maintained coverage.Results: Nearly 1 in 4 Marketplace beneficiaries disenrolled midyear. The hazard rate of disenrollment was 30% lower for individuals in plans receiving cost-sharing reductions and 21% lower for those enrolled in gold plans, compared with silver plans without cost-sharing subsidies. Young adults had a 70% increased hazard of disenrollment compared with older adults. Those who disenrolled midyear had greater hospital and emergency department utilization before disenrollment compared with those who maintained continuous coverage.Conclusions: Plan generosity is significantly associated with lower disenrollment rates from Marketplace coverage. Reducing churning in Affordable Care Act Marketplaces may improve continuity of care and insurers' ability to accurately forecast the health care costs of their enrollees. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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