Medicare HMO Beneficiaries Worry About Health Care Coverage
When Their Health Plans Terminate
New Fact Sheet Presents an Unsettling Picture of the Status of
People Whose Plans Left the Program in January 2000
Contact: Marsha Gold, (202) 484-4227, or Joanne Pfleiderer, (609) 275-2372
WASHINGTON, D.C. (September 18, 2000)—Many Medicare+Choice beneficiaries face limited choices when their plans leave the turbulent managed care market. A new fact sheet from Mathematica Policy Research, Inc., provides one of the first looks at what happened to people whose plans left the program in January 2000, including their knowledge of alternative options and ability to maintain coverage either through fee-for-service plans or another HMO. The publication, which is based on a national survey of Medicare beneficiaries, shows they are more worried this year than last about paying health care bills and out-of-pocket costs for drug coverage. "Forced Exit: Beneficiaries in Plans Terminating in 2000," the third in a series of Fast Facts on Medicare+Choice, also describes the characteristics of those who are enrolled in plans that terminate, noting that they are generally more vulnerable when compared with all Medicare+Choice enrollees.
"Terminations affected a disproportionately vulnerable subgroup of beneficiaries, many of whom were confused about their options and worried about the future," said Marsha Gold, director of the study and a senior fellow at Mathematica®. "In addition, regardless of their coverage, beneficiaries are worried about prescription drug costs. The current structure of Medicare does not seem to be meeting these needs."
Nationwide, 327,000 Medicare+Choice enrollees were in plans that ceased serving their counties in 2000, which represents about 5 percent of those enrolled in Medicare+Choice plans. Policymakers will find it especially important to understand what happened to those beneficiaries, since a larger group--nearly three times as many beneficiaries--will be affected in 2001.
The fact sheet is part of a three-year study focused on how Medicare beneficiaries are faring under Medicare+Choice. A companion fact sheet, "Trends Reflect Fewer Choices," examines the erosion of choice and benefits through 2001, including changes in penetration rates for individual states and changes in choice among urban and rural areas. The first fact sheet in the series, published in 1999, covered trends in enrollment and choice through 2000, including the relationship between withdrawals and payment rates and the role of particular national firms. The second fact sheet profiled variation in choice and benefits across individual urban markets.
The project, funded by the Robert Wood Johnson Foundation, involves a mixed design of broad-based national analysis and targeted community studies.
Copies of all of the fact sheets, along with a more detailed description of the study, can be found on the Mathematica web site at www.mathematica-mpr.com/med+choicehot.asp. Call Publications at (609) 275-2350 for printed copies.
Mathematica®, one of the nation's leading independent research firms, conducts policy research and surveys for federal and state governments, foundations, and private-sector clients. The employee-owned firm, with offices in Princeton, N.J., Washington, D.C., and Cambridge, Mass., has conducted some of the most important studies of health care, welfare, education, employment, nutrition, and early childhood policies and programs in the U.S. Mathematica strives to improve public well-being by bringing the highest standards of quality, objectivity, and excellence to bear on the provision of information collection and analysis to its clients.
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