Medicare Advantage enrollees more likely to disenroll after new complex diagnosis

A new study indicates Medicare Advantage enrollees are significantly more likely to leave their MA plan after receiving a new, complex diagnosis like cancer or heart failure. This patient churn, often back to traditional Medicare, disrupts care continuity and creates administrative overhead for practices. The trend suggests some MA plans may be failing to adequately support high-need members, leading to dissatisfaction. For billing teams, this underscores the importance of verifying a patient's coverage at every visit, especially following a major diagnosis, as their payer may have changed. It also highlights a potential financial risk for MA-focused practices if their sickest patients consistently exit the plan.