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Expert Insight

What commercial insurance beneficiary 'churn' means for VBC

Commercial insurance beneficiaries typically stay with their health plan for less than two years, making it difficult for stakeholders to benefit from long-term initiatives in cost and care management. However, many enrollees eventually return, underscoring the value of longer-term strategies for their patient population.

The window for reducing costs is shorter with patients on commercial plans rather than traditional Medicare, giving commercial plans less time to reduce costs and generate savings. So just how much time do commercial plans, provider, organizations, and their partners have to reduce costs for their patient populations?

What we did

Our team analyzed a robust database of commercial claims with nationwide coverage to understand how long beneficiaries stay with their health plan — and if and when those who leave their plan return. The database includes employer-sponsored insurance and insurance purchased on the individual market.

When we talk about "churn," we're referring to patients switching between health carriers. Commercial patient churn happens most often at three levels: 

  • Patients switching health carriers when changing employers
  • Employers changing their employee health carriers
  • Patients switching health carriers via the individual market

The time horizon for commercial savings is short — but some enrollees will return 

On average, commercial insurance beneficiaries stay with their health plans for less than two years.  

In addition, about 40% of beneficiaries leave their health plan within 12 months of joining it. But that also means that 60% stay with their plan for more than 12 months. 


SPONSORED BY

INTENDED AUDIENCE
  • Employers
  • Health plans
  • Hospitals and health systems

AFTER YOU READ THIS
  • You’ll gain insight into the reality of commercial patient churn and how long beneficiaries stay with their health plan  
  • You’ll learn how to capitalize on the short-term window of opportunity to reduce costs in a commercial VBC contract 

AUTHORS

Phoebe Donovan

Consultant, Quantitative insights

TOPICS

INDUSTRY SECTORS

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