High churn among sickest Medicare Advantage patients strains long-term care investments

A new report details significant patient churn among the sickest Medicare Advantage enrollees, undermining payer investments in long-term care management programs. Members with complex, chronic conditions are disenrolling from MA plans at higher rates, often during annual election periods, which disrupts care continuity and negates upfront investments by insurers like UHC and Humana. This volatility complicates predictive modeling for risk-adjusted payments and creates administrative instability for providers contracted with these plans. The trend suggests MA plans may tighten prior authorization or implement more stringent care management protocols for high-cost populations to protect margins.