The Effect of Plan Switching on Access and Quality of Care in Medicaid

Chris Frenier, MPH
HSRP&A Doctoral Candidate
Division of Health Policy & Management

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Medicaid programs increasingly rely on competition between managed care plans to reduce costs and improve quality. Most states use competitive bidding to select Medicaid managed care (MMC) plans to include on the menu of plan choices for their Medicaid beneficiaries. While bidding can facilitate quality and cost competition among insurers, the need for states to reject noncompetitive plans means that some people may have to involuntarily switch MMC plans. Switching could negatively affect enrollees if they lose access to providers or experience disruptions in their care related to having to change MMC plans. Previous research finds that discontinuities in Medicaid coverage disrupt access to care, but little is known about how plan switching without loss of coverage affects quality and access.

Frenier uses data from the Minnesota All Payer Claims Database to examine how Minnesota’s 2016 Medicaid and MinnesotaCare re-contracting affected enrollees who were forced to switch managed care plans. This research has important implications for policy makers balancing the trade-offs between competition and continuity of care in Medicaid.

HPM Seminar Series is sponsored by the Division of Health Policy & Management, School of Public Health, University of Minnesota.