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The performance of Medicare, Medicaid, and individual commercial products.

作者信息

Howard Diane M, Croke Kevin, Mensah Edward, Mullner Ross

机构信息

Health Systems Management, Rush University, Chicago, USA.

出版信息

J Healthc Manag. 2006 May-Jun;51(3):156-68; discussion 169-70.

Abstract

Medicare, Medicaid, and individual nongovernmental insurance products are marketed by commercial health insurance companies. We propose that the product offerings be viewed as a group rather than as separate products competing for internal company resources. A study population consisting of 35 Aetna plans in 24 states, 124 Blue Cross Blue Shield plans (BCBS) in 45 states and the District of Columbia, 43 Cigna plans in 28 states, and 23 UnitedHealth plans in 22 states was examined on 29 variables, including financial, marketing, and medical management data. The findings revealed that Medicaid and individual nongovernmental products were terminated more often than other products across all ownership types. When BCBS plans were analyzed across for-profit, nonprofit, and mutual ownership types, the companies had distinct preferences for product offerings. The study provided evidence that health plans will limit their exposure to Medicare, Medicaid, and individual nongovernmental products in preference to comprehensive/group products.

摘要

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