title: Selection experiences in Medicare HMOs: pre-enrollment expenditures.
abstract: Using 1993 and 1994 data, the authors examine whether beneficiaries who enroll in a Medicare health maintenance organization (HMO), including those enrolling for only a short period of time, have lower expenditures than continuous fee-for-service (FFS) beneficiaries the year prior to enrollment. We also test whether biased selection varies by the level of HMO market penetration and the rate of market-share growth. We find favorable selection associated with enrollment into Medicare HMOs, which declines as market share increases but does not disappear. Among short-term enrollees, we find unfavorable selection, however, selection bias was not sensitive to market characteristics.
authors.affiliation: University of Minnesota, USA. callx001@tc.umn.edu
authors.forename: K T
authors.initials: KT
authors.lastname: Call
authors.forename: B
authors.initials: B
authors.lastname: Dowd
authors.forename: R
authors.initials: R
authors.lastname: Feldman
authors.forename: M
authors.initials: M
authors.lastname: Maciejewski
mesh_terms: D000368:Aged; D014487:Centers for Medicare and Medicaid Services, U.S.; D003191:Comprehensive Health Care / Q000191:economics / Q000706:statistics & numerical data*; D003625:Data Collection; D018588:Fee-for-Service Plans / Q000191:economics / Q000706:statistics & numerical data; D005102:Health Expenditures; D006279:Health Maintenance Organizations / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D015273:Insurance Selection Bias; D006278:Medicare / Q000706:statistics & numerical data*; D017059:Models, Econometric; D014481:United States