Health expenditures for privately insured adults enrolled in managed care gatekeeping vs indemnity plans.

OBJECTIVES: We assessed the ability of managed care gatekeeping strategies (i.e., requiring a designated primary care provider to authorize referrals) to control health care costs in the mid-1990s. METHODS: We analyzed expenditure data from 8195 privately insured adults sampled in the nationally rep...

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Publicado en:American Journal of Public Health Vol. 95; no. 2; pp. 286 - 292
Autores principales: Pati S, Shea S, Rabinowitz D, Carrasquillo O
Formato: research tables/charts Journal Article
Publicado: American Public Health Association Feb2005
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2005
      vid: 95
      iid: 2
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      pub: American Public Health Association
      place: Washington, District of Columbia
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        atl: Health expenditures for privately insured adults enrolled in managed care gatekeeping vs indemnity plans.
      aug:
        au:
          Pati S
          Shea S
          Rabinowitz D
          Carrasquillo O
        affil: Departments of Pediatrics and Internal Medicine, Columbia University College of Physicians & Surgeons, New York, NY
      sug:
        subj:
          Cost Control
          Gatekeeping
          Health Care Costs Evaluation
          Insurance, Health
          Managed Care Programs Economics
          Adult
          Chi Square Test
          Comparative Studies
          Cost Savings
          Costs and Cost Analysis
          Data Analysis Software
          Descriptive Statistics
          Fee for Service Plans
          Female
          Funding Source
          Health Maintenance Organizations
          Health Resource Utilization
          Male
          Middle Age
          Models, Statistical
          Multiple Logistic Regression
          Multiple Regression
          P-Value
          Panel Studies
          Private Sector
          Probability
          Surveys
          T-Tests
          Two-Tailed Test
          United States
          United States Agency for Healthcare Research and Quality
          Human
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Female
          Male
      ab: OBJECTIVES: We assessed the ability of managed care gatekeeping strategies (i.e., requiring a designated primary care provider to authorize referrals) to control health care costs in the mid-1990s. METHODS: We analyzed expenditure data from 8195 privately insured adults sampled in the nationally representative 1996 Medical Expenditure Panel Survey. Managed care gatekeeping plan enrollees included those in health maintenance organizations and other plans requiring a primary care gatekeeper. All others were considered indemnity plan enrollees. RESULTS: In 1996, total per capita annual health expenditures for adult gatekeeping enrollees were about $50 less than those of indemnity enrollees, primarily owing to lower out-of-pocket expenditures. After multivariate adjustment, mean per capita expenditures were approximately 6% lower for gatekeeping enrollees than for indemnity enrollees. CONCLUSIONS: In the private sector, gatekeeping strategies resulted in modest cost savings over indemnity plans.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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