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Medicare: Many HMOs Experience High Rates of Beneficiary Disenrollment

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Report Type Reports and Testimonies
Report Date April 30, 1998
Report No. HEHS-98-142
Subject
Summary:

Included in the Balanced Budget Act of 1997 is a mandate that the Health Care Financing Administration (HCFA) make comparative information available to Medicare beneficiaries, including data on health plan disenrollment rates, so that they can make informed choices about health maintenance organizations (HMO). The disenrollment data will be required by the fall of 1999, but it is unclear whether HCFA must publish disenrollment data for HMOs in business less than two years. GAO evaluated the feasibility of computing voluntary disenrollment rates for HMOs from readily available data and analyzed the extent to which these rates vary among plans. Disenrollment rates varied substantially; in many markets, the highest disenrollment rates exceeded the lowest by more than fourfold. Although the data indicate that competing plans vary widely in their ability to retain members, they do not reveal why.

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