1, FHS will have ceased offering its HMO product in 82 counties, affecting 57,000 Medicare enrollees
The screening/assessment pro,ram can be utilized for new Medicaid/medicare managed care enrollees
to provide early referral of cases to case managers and specialists as well as identify current enrollees
with emerging chronic or high-tisk conditions.
In July 1997, the New England Journal of Medicine published a study comparing hospital utilization rates among HMO and FFS Medicare enrollees
in the year before the HMO enrollees
left FFS Medicare to join an HMO, and in the three months after some of the HMO enrollees
disenrolled and returned to FFS Medicare.
It will be difficult for the program to implement cuts to the rates it pays physicians, or to expand coverage to two to three million new enrollees
without widening the gap in access to care between Medi-Cal enrollees
and the general insured population - and running afoul of federal law requiring equal access to services.
The best measure of hospital day utilization is patient days per 1,000 enrollees
per year ("enrollee
" includes the employee and his or her enrolled spouse and children).
Although OPM had promised that the new self-plus-one option would lower costs for enrollees
, in some cases enrollees
will be charged more for selecting the self-plus-one plan than they will if they stay in the family plan.
To control for differences in benefit generosity, we also constructed three measures of the cost sharing faced by enrollees
in each BCBS plan: one specific to prescription drugs, another for physician visits, and a third for all nonprescription drug utilization.
One certain reason enrollees
are continually satisfied is that 2012 premiums are lower on average than 2011 premiums.
Costs for enrollees
have been higher than anticipated, possibly because of deferred health care prior to their enrollment, he said.
Prices increased at similar rates for the 96 drugs frequently used by BCBS FEP Medicare enrollees
and the 91 drugs frequently used by BCBS FEP non-Medicare enrollees
The data for this analysis were drawn from surveys of 16,700 SCHIP enrollees
fielded in 10 states in 2002.
During the past year, 26 percent of CDHP enrollees
didn't fill a prescription because of cost, compared to only 15 percent in traditional plans.