Choice of Payment Plan in the Medicare Capitation Demonstration

Garfinkel, Steven; Schlenger, William E.; McLeroy, Kenneth R.; Bryan, Fred A.; York, Bradley; Dunteman, George H.; Friedlob, Alan S.

doi:10.1097/00005650-198607000-00006

Cited by 23 publications

(8 citation statements)

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“…Most of the studies show evidence that those who choose to join HMOs are healthier than those who do not. Hill and Brown (1990), Brown, Bergeson, and Clement (1993), Garfinkel et al (1986) and Eggers and Prihoda (1982) found this to hold true for those in Medicare programs, while Cutler and Reber (1998), Glied et al (1997), Robinson, Gardner and Luft (1993), Altman, Cutler, and Zechauser (1998) found this true in other populations.…”

Section: Literature Reviewmentioning

confidence: 95%

Treatment effects of selection behavior in managed care plans: evidence from Medicaid

Gomes

2003

Portuguese Economic Journal

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This paper tests whether capitated payments to Medicaid managed care plans induce to plans' strategic undercutting of treatment for specific diagnostic groups. I focus on treatment (measured by length of stay and cost) in acute care hospitals in Massachusetts. I use a "differences-in-differences-in-differences" approach, where the third differences compare treatment patterns between managed care plans that receive capitated payments with those that do not. I find that the first reduce treatment significantly more to mental health patients than to patients in other disease groups, whereas the latter reduce hospital resource use more uniformly across disease groups. These results highlight the importance of using payment mechanisms in public programs that reflect the variability in costs of beneficiaries.

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Section: Literature Reviewmentioning

confidence: 95%

Treatment effects of selection behavior in managed care plans: evidence from Medicaid

Gomes

2003

Portuguese Economic Journal

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“…However, findings about the effect of health risk on the choice of HMOs have not been consistent (Garfinkel, Schlenger, McLeroy, Bryan, York, Dunteman, & Friedlob, 1986;Juba, Lave, & Shaddy, 1980;Wilensky & Rossiter, 1986). Two studies found that health risk was not a significant determinant of choice (Feldman, Finch, Dowd, & Cassou, 1989;Grazier, Richardson, Martin, & Diehr, 1986).…”

Section: Health Riskmentioning

confidence: 99%

“…However, due to the difficulty of surveying enrollees during this narrow window of opportunity, investigators have rarely heeded this advice (Davis et al, 1995;Feldman et al, 1989;Taylor et al, 1995). In some studies, data collection occurred 11 to 24 months after enrollment (Grazier et al, 1986;Garfinkel et al, 1986).…”

Section: Samplementioning

confidence: 99%

Elaborating a Dichotomous Measure of Enrollment Choice

Thomas

2004

Social Work in Health Care

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The objective of this study is to make health insurance plans more responsive to the needs of people by identifying plan characteristics that are important to consumers during their enrollment decisions. Employees from three companies were surveyed. Factor analysis indicated four dimensions of plans that are important to consumers: cost, freedom, quality, and psychosocial access. Among characteristics that described the "cost dimension" of plans, unpredictable out-of-pocket costs was the most important. Among characteristics that described the "freedom" dimension of plans, freedom to go to any doctor without authorization from the primary care physician was most important.

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“…Chronic illnesses that require frequent office visits may, however, influence choice. Health status of respondents was included in the list of explanatory variables, because earlier studies (Garfinkel et al 1986) indicate a relationship between one's health status and choice of provider plan/preference of physician. Information on average out-of-pocket costs encountered in each plan was not available, although many studies (Long, Settle, and Wrightson 1988) have indicated this as important in influencing decision making.…”

Section: Dependent and Independent Variablesmentioning

confidence: 99%

“…In the area of health care research, Garfinkel et al (1986) investigated factors contributing to health maintenance organization (HMO) enrollment with the aid of logistic regression models, and Long, Settle, and Wrightson (1988) studied HMO disenrollment patterns using multivariate probit analysis. However, few articles in health care research have investigated modeling structures that ilivolve more complex decision making by the consumer.…”

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confidence: 99%

Evaluation of Behavioral Demand Models of Consumer Choice in Health Care

Siddharthan

1991

Eval Rev

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This article investigates the choice of provider plan (fee for service and health maintenance organizations) and preference for a personal physician by Medicare beneficiaries with the aid of a joint logit (JL) and a nested logit (NL) model The NL model, where the lower level is the choice pertaining to preference for a personal physician and the higher level is the choice of provider plan, better explains consumer behavior. Family income levels and access to adequate transportation capabilities are shown to be important criteria used by the elderly in choosing a provider plan.In recent years, quantal choice models have been used more fre-I quently to study consumer behavior in diverse fields including finance (Carroll, Szumpano, and Elder 1988), labor markets (Bishop and Montgomery 1986; Cremer and Gathon 1987), and preferences relating to housing (Borch-Supan and Pitkin 1988). In the area of health care research, Garfinkel et al. (1986) investigated factors contributing to health maintenance organization (HMO) enrollment with the aid of logistic regression models, and Long, Settle, and Wrightson (1988) studied HMO disenrollment patterns using multivariate probit analysis. However, few articles in health care research have investigated modeling structures that ilivolve more complex decision making by the consumer. In today's health care market, the availability of alternatives to health care consumers has been altered by the advent of managed care plans, stricter utilization reviews, and many other AUTHOR'S NOTE: r/~aM~or~M/t~toac~tOM'/ed~M~MD~/t~ P/t.D., andCAar/e.s~re~,

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Choice of Payment Plan in the Medicare Capitation Demonstration

Cited by 23 publications

References 0 publications

Treatment effects of selection behavior in managed care plans: evidence from Medicaid

Treatment effects of selection behavior in managed care plans: evidence from Medicaid

Elaborating a Dichotomous Measure of Enrollment Choice

Evaluation of Behavioral Demand Models of Consumer Choice in Health Care

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