Limits...
Health care use and expenditures of Medicare HMO disenrollees.

Parente ST, Evans WN, Schoenman JA, Finch MD - Health Care Financ Rev (2005)

Bottom Line: With data from CMS and United Health Group, we estimate use and expenditure changes between 1998 and 1999 for HMO enrollees who were involuntarily dropped from their plan and returned to fee-for-service (FFS) Medicare using a difference-in-difference model.Compared to those who voluntarily left an HMO, involuntarily disenrolled beneficiaries had higher out-of-pocket expenditures, an 80 percent decrease in physician visits, 38 percent higher emergency room (ER) use and a higher probability of dying.The results suggest beneficiaries face significant costs and reduced health outcomes from unstable Medicare managed care markets.

View Article: PubMed Central - PubMed

Affiliation: University of Minnesota, Department of Finance, Carlson School of Management, Minneapolis 55455, USA. sparente@csom.umn.edu

ABSTRACT
We examine the impact of the first wave of Medicare health maintenance organization HMO withdrawals. With data from CMS and United Health Group, we estimate use and expenditure changes between 1998 and 1999 for HMO enrollees who were involuntarily dropped from their plan and returned to fee-for-service (FFS) Medicare using a difference-in-difference model. Compared to those who voluntarily left an HMO, involuntarily disenrolled beneficiaries had higher out-of-pocket expenditures, an 80 percent decrease in physician visits, 38 percent higher emergency room (ER) use and a higher probability of dying. The results suggest beneficiaries face significant costs and reduced health outcomes from unstable Medicare managed care markets.

Show MeSH

Related in: MedlinePlus

CMS and UnitedHealth Group Combined Study Population Development: 1998-1999
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4194938&req=5

f1-hcfr-26-3-031: CMS and UnitedHealth Group Combined Study Population Development: 1998-1999

Mentions: Combining the Medicare data with claims and administrative files from UnitedHealth was challenging due to structural differences in the two sources of data and timing of the data requests to complete the study. Figure 1 describes the selection of the study comparison population. The following are the four population development steps.


Health care use and expenditures of Medicare HMO disenrollees.

Parente ST, Evans WN, Schoenman JA, Finch MD - Health Care Financ Rev (2005)

CMS and UnitedHealth Group Combined Study Population Development: 1998-1999
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4194938&req=5

f1-hcfr-26-3-031: CMS and UnitedHealth Group Combined Study Population Development: 1998-1999
Mentions: Combining the Medicare data with claims and administrative files from UnitedHealth was challenging due to structural differences in the two sources of data and timing of the data requests to complete the study. Figure 1 describes the selection of the study comparison population. The following are the four population development steps.

Bottom Line: With data from CMS and United Health Group, we estimate use and expenditure changes between 1998 and 1999 for HMO enrollees who were involuntarily dropped from their plan and returned to fee-for-service (FFS) Medicare using a difference-in-difference model.Compared to those who voluntarily left an HMO, involuntarily disenrolled beneficiaries had higher out-of-pocket expenditures, an 80 percent decrease in physician visits, 38 percent higher emergency room (ER) use and a higher probability of dying.The results suggest beneficiaries face significant costs and reduced health outcomes from unstable Medicare managed care markets.

View Article: PubMed Central - PubMed

Affiliation: University of Minnesota, Department of Finance, Carlson School of Management, Minneapolis 55455, USA. sparente@csom.umn.edu

ABSTRACT
We examine the impact of the first wave of Medicare health maintenance organization HMO withdrawals. With data from CMS and United Health Group, we estimate use and expenditure changes between 1998 and 1999 for HMO enrollees who were involuntarily dropped from their plan and returned to fee-for-service (FFS) Medicare using a difference-in-difference model. Compared to those who voluntarily left an HMO, involuntarily disenrolled beneficiaries had higher out-of-pocket expenditures, an 80 percent decrease in physician visits, 38 percent higher emergency room (ER) use and a higher probability of dying. The results suggest beneficiaries face significant costs and reduced health outcomes from unstable Medicare managed care markets.

Show MeSH
Related in: MedlinePlus