Performance Improvement 2004. Medicare Beneficiaries Who Involuntarily Disenroll from their Health Plans


The purpose of this survey was to collect data that will help CMS understand how Medicare beneficiaries are affected by Medicare health plan withdrawals and reductions in service areas. Understanding the difficulties some beneficiaries may have in response to changes in the health care system will help CMS meet its goal of providing all Medicare beneficiaries with adequate health care. The survey included a sample of Medicare beneficiaries who were enrolled in managed care plans that either terminated their risk contracts or reduced their service areas as of January 1, 2002. The survey was conducted as a mail survey with telephone follow-up of non-respondents. The findings show that there are some clear differences between involuntary disenrollees in vulnerable and less vulnerable subgroups regarding their understanding of the options available to them and the implications of plans withdrawing from the Medicare program. Overall, the incidence of potentially negative impacts of plan withdrawals, such as disruption in provider arrangements and reduced access to care, appears to have affected relatively fewer beneficiaries in 2002 than in 2001. However, those in vulnerable subgroups such as the disabled, those in poor health, and those with less education, continued to be more likely to experience negative consequences than other beneficiaries. Furthermore, there was no observed improvement in the level of awareness of options or understanding of what would happen when a plan stopped covering its beneficiaries.

PIC ID: 7421
Agency Sponsor: CMS, Office of Research, Development & Information
Federal Contact: Riley, Gerald, 410-786-6699
Performer: University of Wisconsin, Madison, WI

View full report


"pi_2004.pdf" (pdf, 713.01Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®