Medicare Advantage consumers loyal to MA, but not to insurer, study finds

A new study by the Kaiser Family Foundation shows the majority of enrollees to Medicare Advantage plans stay with the plan and will only switch if premiums rise by more than $20 a month.

Most, 79 percent of MA enrollees in 2013, faced premium increases of less than $10, which could explain why only one in 10 Medicare Advantage enrollees voluntarily switched to another MA plan between 2013 and 2014, according to the study released Tuesday.

MA enrollees switch plans at a similar rate as Medicare prescription drug plan enrollees, but at much lower rates than enrollees in Affordable Care Act marketplace plans, the study said. Marketplace enrollees between 2015 and 2016 switched plans at a rate of 43 percent, the study said.

[Also: Medicare Advantage attracting healthcare providers looking to run their own plans]

The reason could be the savings on premiums. Marketplace enrollees who switched plans saved more than twice as much on premiums than Medicare Advantage enrollees, $504 to $210, respectively.

Medicare Advantage enrollees who switched saved $15.87 per month in premiums, on average, and lowered their out-of-pocket limit by $401.

While the analysis shows some price sensitivity, the study said that many senior citizens would rather pay a bit more in premiums to avoid the hassle of switching. Seniors interviewed said the difference in plans is not important enough to warrant their time and effort.

Some may place a higher value on other factors such as having access to specific doctors. Age is also a factor, with those ages 65 to 75 years old more willing to switch than consumers in their 80s.

[Also: CMS releases Medicare Advantage value-based insurance design model]

In 2013, 11 percent of enrollees voluntarily switched MA plans while 78 percent stayed in the same plan; 2 percent switched to traditional Medicare; another 5 percent involuntarily switched and 3 percent died.

Among those that did voluntarily switch, the majority, 71 percent, went with a plan offered by another insurer.

The most loyal consumers were those with an HMO plan. Eighty-one percent of HMO enrollees switched to another HMO plan.

The rate on the number of enrollees switching has remained relatively constant between 2007 and 2013, the study said.

This is noteworthy given the number of changes in Medicare Advantage policies and payments implemented during these six years, the authors said.

[Also: Aetna, Humana to sell Medicare Advantage business in 21 states]

Also noteworthy is that those who switched were in plans with lower quality ratings. Between 2013 and 2014, one in seven enrollees in plans with a 2 or 2.5 star quality rating switched, compared to one in 10 with 4 or 4.5 star rating, and only one in 30 for those in 5 star plans. Those who switched ended up in a plan with only modestly higher quality ratings.

Kaiser Permanente has consistently low switching rates of 2 to 4 percent, while other plans rates fluctuated over the years, but overall are 10 percent.

The study suggests the low rates for Kaiser could be due to its integrated delivery system, which would require enrollees to change doctors if they switched plans.

Switching rates were lower for dual eligibles in Medicare Advantage Special Needs Plans. Each year, Medicare Advantage enrollees have the opportunity to change plans during an annual enrollment period.

Prior research shows that roughly the same share of beneficiaries, 5 percent, shift between Medicare Advantage and traditional Medicare each year, that most enrollees tend to stay in a Medicare Advantage plan once in Medicare Advantage, and that switching rates from Medicare Advantage to traditional Medicare are higher among high-need, high-cost patients.

Twitter: @SusanJMorse