Medicare HMO enrollees receive more preventive care services than their fee-for-service counterparts. This might be due to the enrollment into HMOs of beneficiaries who are more disposed to use preventive care. To investigate this possibility, we examined the use of four preventive care services by respondents to the 1996 Medicare Current Beneficiary Survey. Unadjusted preventive care use rates for HMO enrollees were slightly higher than rates for non-HMO enrollees with private supplemental insurance. However, after adjusting for sociodemographic characteristics, health behaviors, health status and functioning, preventive care use rates for HMO enrollees were substantially higher. Because HMO enrollees are of lower socioeconomic status and have poorer health behaviors, they are less disposed to use preventive care. We conclude that Medicare HMOs experience significant adverse selection in terms of patient propensity to use clinical preventive services. In our presentation, we will discuss these findings in the broader context of the relationship between socioeconomic status and putative measures of health plan performance.
Learning Objectives: N/A
Keywords: Managed Care, Report Card
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.