What drives Medicare managed care growth?

• Published in: Health Affairs Vol. 18; no. 6; pp. 140 - 149
• Main Authors: Brown, R S, Gold, M R
• Format: Journal Article
• Language: English
• Published: United States Health Affairs 01.11.1999; The People to People Health Foundation, Inc., Project HOPE
• Subjects: Attitude to Health; Beneficiaries; Capitation; Capitation Fee - organization & administration; Case studies; Contractors; Enrollments; Expectations; Florida; Government programs; Health care; Health care policy; Health Care Sector; Health maintenance organizations; Health Services Research; HMOs; Humans; Insurance Benefits; Insurance Coverage - organization & administration; Los Angeles; Managed care; Managed Care Programs - organization & administration; Market economies; Market forces; Markets; Medicare; Medicare - organization & administration; New York City; Policy making; Practice Patterns, Physicians' - organization & administration; Public policy; Statistical analysis; Statistics; Studies; Surveys and Questionnaires; United States; Washington; New York City; Los Angeles; Florida; United States; Washington; United States > US; New York; Los Angeles California
• ISSN: 0278-2715; 1544-5208
• DOI: 10.1377/hlthaff.18.6.140

We conducted case studies of four markets--Los Angeles, New York City, Portland (OR), and Tampa-St. Petersburg--to learn more about why Medicare managed care develops differently across the country even when capitation rates are similar. Our analysis highlights the importance of prior managed care history, beneficiary characteristics, supplemental coverage patterns, the form of provider organization, practice patterns, care expectations, and other market characteristics to the development of Medicare managed care. Policymakers seeking to expand Medicare managed care need to go beyond national statistics to understand how local market forces affect its growth.