At first glance, that leaves health plans with a limited window to see the financial benefits of care management initiatives for almost half of their patient population.  

However, the data tell a more nuanced story. After two years, approximately 7% of enrollees that joined a plan between 2016 and 2018 returned — and 18% returned to their plan within four years of enrolling.  

This means that while the initial horizon for cost savings is far shorter than in Medicare, commercial plans are likely to see some enrollees again, underscoring the value of taking a longer-term view when identifying the best cost and care management strategies for their patient population. 

Commercial patient churn is concentrated among younger adults who are more likely to leave their plan within one year of joining — a trend that could be the result of these adults changing jobs more regularly than older adults.  

Meanwhile, older adults and children are more likely to remain with their plan for at least four years.  

This is a trend that isn't going away, with the percentage of beneficiaries who stay with their plan for at least four years holding steady across time.

This is good news for health plans who want to implement medium-term care management initiatives and see a return, as these are the age groups associated with many top cost drivers of commercial spend. 

It's easy to discount enrollees below the age of 65 for care management initiatives that take many years to see a return on investment, whether that be in better care outcomes or cost savings. 

Based on our analysis, we found there is still opportunity: many younger adults will return to their plan and a substantial portion of older adults and children stay with their plan for at least four years.  

To capitalize on the reality of commercial churn, plans need to tailor their care initiatives based on who their patient population is and their likely care needs across the medium term.