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Medicare HMOs: Rapid Enrollment Growth Concentrated in Selected States

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Report Type Reports and Testimonies
Report Date Jan. 18, 1996
Report No. HEHS-96-63
Subject
Summary:

Private-sector insurers cite extensive use of health maintenance organizations (HMO) and other managed care approaches as a key factor in slowing the growth of their insurance premiums. As a result, part of the current interest in controlling Medicare costs has centered on ways to increase HMO use among Medicare beneficiaries. This report provides information on trends in the number of (1) Medicare beneficiaries enrolling in HMOs and (2) HMOs enrolling beneficiaries. GAO analyzes this data for factors that might be influencing decisions by HMOs to enroll Medicare beneficiaries and decisions by beneficiaries to enroll in HMOs. GAO found that about 2.8 million Medicare beneficiaries--about seven percent of the total--were enrolled in risk-contract HMOs as of August 1995. This was double the percentage enrolled in 1987. The growth has been particularly rapid during the past four years and has centered on certain states. California and Florida, for example, have more than half of all enrollees.

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