Disease-Specific Plan Switching between Traditional Medicare and Medicare Advantage

Sungchul Park, Paul Fishman, Lindsay White, Eric B. Larson, Norma B. Coe

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Introduction: Previous research has reported switching from traditional Medicare (TM) to Medicare Advantage (MA) plans increased from 2006 to 2011 at the aggregate level, and switching from MA plans to TM also increased. However, little is known about switching behavior among individuals with specific chronic diseases. Objective: To examine disease-specific switching patterns between TM and MA to understand the impact on MA plans. Methods: Using the 2006 to 2012 Medicare Current Beneficiary Survey, we examined disease-specific switching rates between TM and MA and disease-specific ratios of mean baseline total Medicare expenditures of beneficiaries remaining in the same plan (stayers) vs those switching to another plan (switchers), respectively. We focused on beneficiaries with 1 or more of 10 incident diagnoses. Results: Beneficiaries with a new diagnosis of Alzheimer disease and related dementias, hypertension, and psychiatric disorders had relatively high rates of switching into MA plans and low rates of switching out of MA plans. Among those with new diagnoses of psychiatric disorders and diabetes, more costly beneficiaries (those with higher costs) switched into MA plans. For cancer, more costly beneficiaries remained in MA plans. Conclusion: Together, these results suggest that MA plans may have not only higher caseloads but also a more costly case mix of beneficiaries with certain diseases than historically was the case. Our findings can help inform MA plans to understand their beneficiaries’ disease burden and prepare for provision of relevant services.

Original languageEnglish
Article number19.059
JournalThe Permanente journal
Issue number1
StatePublished - 2020

Bibliographical note

Funding Information:
This study was supported by the Department of Health Services at the University of Washington and the National Institute of Health (R01 AG049815). Kathleen Louden, ELS, of Louden Health Communicatins performed a primary copy edit.

Publisher Copyright:
Copyright © 2019 The Permanente Press. All rights reserved. 1.


  • Medicare Advantage
  • disease burden
  • plan switching
  • traditional Medicare


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