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Health Plan Switching:

Choice or Circumstance?

May/June 2000
Health Affairs, vol.19, no.3 (May/June 2000): 158-164
Peter J. Cunningham, Linda T. Kohn

hanging Health plans may be beneficial to the extent that it results from consumers’ decisions and preferences about what type of health plan best suits their health care needs. On the other hand, consumers today are not only choosing a plan to finance the use of services, but within that decision are also choosing a delivery system or network of providers. Therefore, changing health plans may lead to a change in physicians, which may prove harmful to continuity of care, access, and quality.

The extent to which changes in health plans are beneficial or potentially harmful depends on the answers to several key questions: How frequently are changes made, especially by vulnerable populations who are already at risk for problems with medical care access and quality? To what extent is changing plans voluntary (for example, consumers exercising choice) or involuntary (for example, forced changes by employers)? How often does changing health plans lead to a change in the place that persons usually receive medical care?

Previous studies have been limited to the experience of a single company, which makes it difficult to generalize to the privately insured population as a whole. Using data from the 1996-1997 Community Tracking Study (CTS) household survey, this study is among the first to examine consumers’ switching among private insurance plans nationwide.

Free access to this article is available at the Health Affairs Web site.


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The Center for Studying Health System Change Ceased operation on Dec. 31, 2013.