Factors that affect the HMO enrollment decision: a tale of two cities.
Although there is agreement that utilization patterns in HMOs differ from those in non-HMO systems, there is less agreement on how and why these differences are achieved. Selection bias is one frequently offered explanation. In an attempt to identify those individual and site-specific factors that help determine employees' choice of coverage, we developed and tested a logistic model of the enrollment decision. We used both survey data and claims data to study the decision to enroll in either an HMO or a traditional indemnity plan among state employees in Tallahassee, Florida, and Salt Lake City, Utah. We found that many factors affected the decision--factors that could be altered by an HMO or insurance company to correct selection bias if and when it is encountered.
D000328:Adult; D003258:Consumer Behavior; D003657:Decision Making; D003669:Deductibles and Coinsurance; D005260:Female; D005431:Florida; D006279:Health Maintenance Organizations / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D010342:Patient Acceptance of Health Care; D014589:Utah