However, since risk selection is driven by enrollee
choice, which is largely a function of enrollee
perceptions of their plan characteristics, the self-reported plan type is the preferred indicator of health plan type for our purposes.
The study found that HMO enrollee
hospital costs were only 55 percent of the cost of FFS enrollees
in the year prior to joining an HMO ($693 versus $1,260 per beneficiary), and that the HMO enrollees
who disenrolled and returned to FFS Medicare incurred hospital costs that were double the costs incurred by FFS enrollees
($644 versus $322 per beneficiary) in the first three months after enrollment.
Ask the insurance carrier for the average number of prescriptions per enrollee
The potential for undercounting may be caused by one or more of several factors: (1) the record for a dual enrollee
may have been missing from either the EDB or the MAX file, (2) SSN may have been missing in the MAX file, or (3) there may have been errors or number transpositions in the recorded SSN.
For example, the typical PACE enrollee
is 79 years old, and about half have a diagnosis of dementia.
To compare adjusted mortality rates of TEFRA-risk HMO enrollees
and disenrollees with rates of beneficiaries enrolled in the Medicare fee-for-service sector (FFS), and to compare the time until death for decedents in these three groups.
igpt] is the outcome measure for enrollee
i enrolled with provider group g and plan p in quarter-year t (e.
To address possible unobserved differences between recent and established enrollees
, models are estimated just with recent enrollees
who stay enrolled in the program for at least 5 months and we subset the established enrollee
sample to those who were enrolled in SCHIP closer to the time period during which children in the recent enrollee
sample were entering SCHIP.
Table 1 compares per eligible payments of the dually eligible with non-dually eligible Medicaid enrollees
based on an analysis of Federal fiscal year (FFY) 2002 Medicaid Statistical Information System (MSIS) data.
It must be visible and of importance to providers, enrollees
, and employers.
Primary care physicians under managed care contracts act as gatekeepers for most or all of the physician services available to enrollees
A CDHP is a high-deductible health plan coupled with a savings account enrollees
use to pay for health care.
with CHF are more likely to report annual household incomes less than $10,000 then the overall M+C enrollee
4% increase in enrollee
share of FEHBP premiums next year
1, affecting enrollees
in 55 Arkansas counties, said Mike Pickens, state insurance commissioner.