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Health Care Financ Rev. 2005 Spring;26(3):31-43.

Health care use and expenditures of Medicare HMO disenrollees.

Author information

1
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.

PMID:
17290626
PMCID:
PMC4194938
[Indexed for MEDLINE]
Free PMC Article
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