13) We were concerned that the differences in the enrollee
characteristics between the no choice and choice groups might result in a different magnitude for the utilization effect in the choice group relative to the no-choice group.
A rapidly growing body of evidence indicates that HMO enrollees
cost less than Medicare enrollees
not just because the former are healthier, but because HMOs deny necessary medical services more frequently than Medicare does.
Capitation payment: A health care provider (either an individual or organization) receives a fixed amount per year, per enrollee
for which he or she agrees to provide a predefined comprehensive health care package.
However, estimates do not include adjustments for undercounting of persons reported as dual enrollee
by Medicare, but not linked to Medicaid (e.
Programs of All-inclusive Care for the Elderly (PACE) is well known for the high-quality clinical outcomes its enrollees
experience and the ability to provide care for vulnerable people in the community (see "PAGE: The Basics").
A retrospective study that tracks the mortality rates and time until death of a random sample of 1,240,120 Medicare beneficiaries in the FF5 sector and 1,526,502 enrollees
in HMOs between April 1, 1993 and April 1, 1994.
a) Health risk score denotes enrollee
health status and expected spending.
Models were estimated on recent and established enrollees
who had been uninsured just before enrolling in SCHIP that included all the demographic and socioeconomic control variables from the core model, a dummy variable for whether the child was a recent or established enrollee
, and a set of terms that interacted that dummy variable with the child's health status, age, and race/ethnicity/ primary language, the parent's educational attainment, and the child's state of residence.
Figure 1 shows the mean Medicaid payments per dually and non-dually eligible enrollees
for FFY 2002.
This will be an excellent way to educate and remind providers and staff of the guidelines and to help notify enrollees
or subscribers that they are due for periodic health examinations and health screenings.
Montclair Medical Associates, a primary care physician group, signed a contract on January 1, 1994, with a health maintenance organization (HMO) to provide a full range of services to enrollees
with IHD and CHF are more likely not to have completed high school than the overall M+C enrollee