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APHA Scientific Session and Event Listing

Recorded presentation

Raji Sundaram, PhD, Mathematics and Statistics, University of North Carolina Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, William Brandon, PhD, MPH, Political Science, University of North Carolina Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, 704-687-3886, wilbrand@email.uncc.edu, and Ashley Dunham, MSPH, Public Policy, University of North Carolina Charlotte, 9201 University City Boulevard, Charlotte, NC 28223.

Research Question: How do multiple-switchers among Medicaid managed care plans differ from those who never switch and those who switch once? No previous study examines multiple-switchers, but this research contributes to a developed literature on HMO plan choice.

Data and Study Setting: Enrollment (N=41.969), reimbursement claims (N=2,474), and a telephone survey (N=656) for three Medicaid program categories in Mecklenburg County NC that had to enroll in one of 5 HMOs or care managed by a community health center. The study period includes enrollees from , 1996 to 30 November 1998.

Methods: Cox's Proportional Hazards Model.

Results: Several independent variables differentiate multiple-switchers from those who never switch or switch only once. The strongest predictor was interruption in Medicaid enrollment, but some utilization variables were also significant.

Importance: Both the HMO and patients benefit when enrollees are comfortable in remaining in a plan. Medicaid Managed care plans should learn what leads to switching and attempt to mitigate those factors.

Learning Objectives: At the conclusion of the session, the participant will be able to

• identify predictors of multiple switching in Medicaid managed care. 2.

Keywords: Medicaid Managed Care, HMOs

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation