TY - JOUR
T1 - The managed care backlash
T2 - Did consumers vote with their feet?
AU - Marquis, M. Susan
AU - Rogowski, Jeannette A.
AU - Escarce, José J.
PY - 2004
Y1 - 2004
N2 - The managed care backlash led many to predict the demise of health maintenance organizations (HMOs). This paper examines trends in HMO enrollment in all metropolitan communities from 1994 to 2000 to identify factors that led to diminishing enrollment in the backlash era and circumstances in which HMOs maintained or expanded their presence. We use a database constructed from a wide variety of sources that describe HMO penetration and other characteristics of all metropolitan statistical areas. We found the backlash is not evidenced in a large degree of consumer switching. However, HMOs were more likely to maintain their presence in areas with high-cost growth and with greater managed care experience. Medicaid HMO growth continued to expand rapidly, indicating the possibility of a two-tiered system in which low-income beneficiaries have less choice than the privately insured.
AB - The managed care backlash led many to predict the demise of health maintenance organizations (HMOs). This paper examines trends in HMO enrollment in all metropolitan communities from 1994 to 2000 to identify factors that led to diminishing enrollment in the backlash era and circumstances in which HMOs maintained or expanded their presence. We use a database constructed from a wide variety of sources that describe HMO penetration and other characteristics of all metropolitan statistical areas. We found the backlash is not evidenced in a large degree of consumer switching. However, HMOs were more likely to maintain their presence in areas with high-cost growth and with greater managed care experience. Medicaid HMO growth continued to expand rapidly, indicating the possibility of a two-tiered system in which low-income beneficiaries have less choice than the privately insured.
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U2 - 10.5034/inquiryjrnl_41.4.376
DO - 10.5034/inquiryjrnl_41.4.376
M3 - Article
C2 - 15835597
AN - SCOPUS:15344338977
SN - 0046-9580
VL - 41
SP - 376
EP - 390
JO - Inquiry
JF - Inquiry
IS - 4
ER -