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How Medicare HMO Withdrawals Affect Beneficiary Benefits, Costs, and Continuity of Care


Results from the 1999 Survey of Experiences with Medicare HMOs

This report examines the effects of Medicare HMO withdrawals on elderly and disabled beneficiaries who were involuntarily disenrolled from their HMO at the end of 1998. Based on a nationally-representative survey, the report describes new insurance arrangements made by beneficiaries after their HMO withdrew and considers the effects of this insurance transition on benefits, costs, and continuity of care. The study finds that most beneficiaries fared relatively well after their Medicare HMO withdrew, but more than a third of all disenrollees experienced a decline in supplemental benefits, nearly 40 percent incurred higher premiums, and over 20 percent had to find a new personal doctor. Beneficiaries who experienced the greatest problems after their HMO terminated coverage tended to be the under-age-65 disabled, racial and ethnic minority beneficiaries, the poor and near-poor, and those reporting fair or poor health. A paper based on the findings in this report appears in the November/December 1999 issue of Health Affairs, Volume 18, Number 6.