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Reasons cited by states for some beneficiaries switching plans included pressure from providers, illnesses that impair decision making, and individuals with opioid addictions trying to obtain more prescriptions.[16] The state officials suggested that retaining dual eligible beneficiaries in DSNPs for a longer period--perhaps 90 or 180 days--would give the plans more opportunity to engage with enrollees and establish care coordination and continuity of care

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There are more nerves in the muscle in the thigh than in the deltoid muscle, and it is easier to find the safe place to do the injection in the upper arm (which is why this is a common used place to give vaccinations i.m.)

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