Abstract

This case-study (n=41,969) of voluntary switching among Mecklenburg County, North Carolina Medicaid managed care plans showed a low switching rate of 14.5 per 100 member-years over 33 months, or 5.3 averaged annually. Population, plan and plan characteristics, claims and telephone survey data were examined to better understand this important behavioral measure. Switching in Medicaid managed care, which is little studied, is contrasted with the extensive literature on middle class switching. Policy implications included the suitability of Medicaid populations for managed care and the need for more research on switching and disenrollment and the Medicaid innovation of neutral health benefits advising.

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