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HEHS-95-159R 1 (1995-05-25)

handle is hein.gao/gaobackvn0001 and id is 1 raw text is: United States GAO General Accounting Office Washington, D.C. 20548 Health, Education and Human Services Division B-261414 May 25, 1995 The Honorable John R. Kasich Chairman, Committee on the Budget House of Representatives Dear Mr. Chairman: Your office asked us to provide you with information on health maintenance organization (HMO) enrollment. This letter presents data on the number of Medicare beneficiaries enrolled in risk-based HMOs, cost-based HMOs, and fee-for-service plans in 1993 and 1994. Between December 1993 and December 1994, the percentage of Medicare beneficiaries enrolled in risk-based HMOs increased from 5.1 to 6.3 percent. Although older beneficiaries had lower enrollment rates than those of the general Medicare population, they also increasingly joined risk-based HMOs. Between 1993 and 1994, the percentage of Medicare beneficiaries aged 75 and older enrolled in risk-based HMOs increased from 4.8 to 6.1 percent. Similarly, for those beneficiaries aged 85 years and older, the percentage increased from 3.9 to 4.7 percent. We have enclosed the following tabulations: -- variable definitions (enclosure 1); -- variable totals, for example, line 1 indicates that 1,821,247 Medicare beneficiaries were enrolled in a risk-based HMO in 1993 (enclosure 2); -- breakdown of enrollment data by state (enclosure 3); -- top 50 counties in total beneficiaries enrolled in 1994, including counties with 10,000 or more Medicare beneficiaries (enclosure 4); -- top 50 counties in percentage of Medicare beneficiaries enrolled in a risk-based HMO in 1994, including counties with 10,000 or more beneficiaries (enclosure 5); GAO/HEHS-95-159R HMO Enrollment Data

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