Serving rural Medicare risk enrollees: HMOs' decisions, experiences, and future plans.
This article identifies factors that influence health maintenance organizations' (HMOs) decisions about offering a Medicare risk product in rural areas; describes HMOs' recent experiences serving rural Medicare risk enrollees; and assesses the potential impact of Medicare program changes on the future willingness of HMOs to offer a Medicare risk product in rural areas. Data for the analysis were collected through interviews with a national sample of 27 HMOs. The results underscore the importance of adjusted average per capita cost (AAPCC) rates in HMOs' decisions to offer Medicare risk products in rural areas, but also indicate that other factors influence these decisions.
Casey
M
M
Rural Health Research Center, University of Minnesota, Minneapolis 55414, USA. mcasey@tc.umn.edu
D000368:Aged; D002204:Capitation Fee; D003659:Decision Making, Organizational; D006279:Health Maintenance Organizations / Q000191:economics*; D006801:Humans; D019458:Insurance Coverage; D006278:Medicare / Q000191:economics / Q000458:organization & administration*; D016134:Organizational Policy; D011907:Rate Setting and Review; D020414:Risk Sharing, Financial; D019035:Rural Health Services / Q000191:economics*; D013659:Tax Equity and Fiscal Responsibility Act; D014481:United States