Why do so few HMOs offer Medicare risk plans in rural areas?
Part of a special section on delivery and financing issues in access to health care services in rural areas of the U.S. A study was conducted to determine the extent to which health maintenance organizations (HMOs) provide services to Medicare beneficiaries in rural areas. The findings revealed th...
| Published in: | Health Care Financing Review Vol. 17; pp. 85 - 98 |
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| Main Authors: | , , |
| Format: | Article |
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HCFA ORDS Publications
Fall 1995
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| Subjects: | |
| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=510379772&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 510379772 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 01958631 HCF jtl: Health Care Financing Review issn: 01958631 maglogo: N pubinfo: dt: Fall 1995 vid: 17 pid: 187 pub: HCFA ORDS Publications artinfo: ui: 510379772 ppf: 85 ppct: 13 formats: fmt: @attributes: type: T tig: atl: Why do so few HMOs offer Medicare risk plans in rural areas? aug: au: Serrato, Carl Brown, Randall S. Bergeron, Jaeanette su: Health maintenance organizations Medicare Rural health services United States sug: subj: United States Health maintenance organizations Medicare Rural health services ab: Part of a special section on delivery and financing issues in access to health care services in rural areas of the U.S. A study was conducted to determine the extent to which health maintenance organizations (HMOs) provide services to Medicare beneficiaries in rural areas. The findings revealed that only 17 of the 38 HMOs that have Medicare risk contracts and provide coverage to commercial clients in rural counties include the rural counties in their Medicare plan service areas. The rural counties in which HMOs offer Medicare coverage have higher adjusted average per capita costs (AAPCCs), bigger populations, and a greater number of physicians per capita than do those rural counties that are excluded from the Medicare risk plans. Interviews with HMOs revealed that low and erratic AAPCCs, scarcity of potential enrollees, lack of negotiating power with physicians, and adverse selection were the main disadvantages to initiating the Medicare plan in rural areas. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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