Abstract：
OBJECTIVE: To examine characteristics of Medicare Advantage (MA) enrollees who use their plan\'s customer service to help plans understand how to better meet members\' needs.
METHODS: National sample of 259,533 respondents to MA Consumer Assessment of Healthcare Providers and Systems survey enrolled in any of the 559 MA contracts in 2022.
METHODS: We assessed the association between self-reported customer service use in the prior 6 months and enrollee demographic, coverage, health, and health care utilization characteristics. We used weighted linear regression models to test for bivariate and multivariate associations between customer service use and enrollee characteristics.
RESULTS: Forty-two percent of MA enrollees reported using customer service in the prior 6 months. Use was 20 percentage points (PP) higher for those in poor vs excellent/very good general health, 13 PP higher for those in poor vs excellent/very good mental health, and 14 PP higher for those reporting 3 or more vs no chronic conditions. Those using customer service more often had lower educational attainment, had limited income and assets, preferred another language to English, and had greater health care utilization.
CONCLUSIONS: MA customer service supports a less healthy, higher-need population with greater-than-average barriers to health care, and so should be designed and staffed to effectively serve medically complex, high-need patients. Commercial plan evidence suggests that continuity in customer service support for a member or a given issue may be helpful. Customer service is an important mechanism for improving quality and addressing health equity.
METHODS: National sample of 259,533 respondents to MA Consumer Assessment of Healthcare Providers and Systems survey enrolled in any of the 559 MA contracts in 2022.
METHODS: We assessed the association between self-reported customer service use in the prior 6 months and enrollee demographic, coverage, health, and health care utilization characteristics. We used weighted linear regression models to test for bivariate and multivariate associations between customer service use and enrollee characteristics.
RESULTS: Forty-two percent of MA enrollees reported using customer service in the prior 6 months. Use was 20 percentage points (PP) higher for those in poor vs excellent/very good general health, 13 PP higher for those in poor vs excellent/very good mental health, and 14 PP higher for those reporting 3 or more vs no chronic conditions. Those using customer service more often had lower educational attainment, had limited income and assets, preferred another language to English, and had greater health care utilization.
CONCLUSIONS: MA customer service supports a less healthy, higher-need population with greater-than-average barriers to health care, and so should be designed and staffed to effectively serve medically complex, high-need patients. Commercial plan evidence suggests that continuity in customer service support for a member or a given issue may be helpful. Customer service is an important mechanism for improving quality and addressing health equity.
摘要：
目的：研究使用其计划客户服务的MedicareAdvantage(MA)参保人的特征，以帮助计划了解如何更好地满足保户的需求。
方法：国家样本259,533名受访者参加了2022年的任何559份MA合同中的MA消费者评估医疗保健提供者和系统调查。
方法：我们评估了前6个月自我报告的客户服务使用情况与登记者人口统计之间的关联，覆盖范围，健康,和医疗保健利用特征。我们使用加权线性回归模型来测试客户服务使用和登记者特征之间的双变量和多变量关联。
结果：42%的MA注册人报告在过去6个月使用客户服务。使用是20个百分点（PP）为那些在穷人与优秀/非常良好的一般健康，13PP较高的那些在穷人与优秀/非常好的心理健康，报告3个或更多的人比没有慢性疾病的人高14PP。那些经常使用客户服务的人受教育程度较低，收入和资产有限，比英语更喜欢另一种语言，并有更大的医疗保健利用率。
结论：MA客户服务支持不太健康的，医疗保健障碍高于平均水平的高需求人群，因此，应该设计和配备有效地为复杂的医疗服务，高需求患者。商业计划证据表明，对会员或特定问题的客户服务支持的连续性可能会有所帮助。客户服务是提高质量和解决卫生公平的重要机制。
方法：国家样本259,533名受访者参加了2022年的任何559份MA合同中的MA消费者评估医疗保健提供者和系统调查。
方法：我们评估了前6个月自我报告的客户服务使用情况与登记者人口统计之间的关联，覆盖范围，健康,和医疗保健利用特征。我们使用加权线性回归模型来测试客户服务使用和登记者特征之间的双变量和多变量关联。
结果：42%的MA注册人报告在过去6个月使用客户服务。使用是20个百分点（PP）为那些在穷人与优秀/非常良好的一般健康，13PP较高的那些在穷人与优秀/非常好的心理健康，报告3个或更多的人比没有慢性疾病的人高14PP。那些经常使用客户服务的人受教育程度较低，收入和资产有限，比英语更喜欢另一种语言，并有更大的医疗保健利用率。
结论：MA客户服务支持不太健康的，医疗保健障碍高于平均水平的高需求人群，因此，应该设计和配备有效地为复杂的医疗服务，高需求患者。商业计划证据表明，对会员或特定问题的客户服务支持的连续性可能会有所帮助。客户服务是提高质量和解决卫生公平的重要机制。
