Impact of HMO withdrawals on vulnerable Medicare beneficiaries.

The Medicare+Choice (M+C) program has faced successive waves of plan withdrawals since 1999. We collected data from 1,055 beneficiaries who were involuntarily disenrolled from a health maintenance organization (HMO) that withdrew from six large markets in 1999 to investigate how they were impacted by the forced change in coverage. Administrative data from this HMO were used to oversample beneficiaries who were perceived to be vulnerable based on their poor health status in the period before the HMO withdrawal.

Insights into problems obtaining care believed necessary as measured by the Medicaid Consumer Assessment of Health Plans Survey (CAHPS).

Background: The Consumer Assessment of Health Plans Survey (CAHPS) is widely used to evaluate health plans; however there are few reports of Medicaid health plan efforts to improve performance as measured by CAHPS.

Objective: Data from CAHPS were analyzed to help plan administrators determine how they might address member reports of problems obtaining care they or their doctor believed necessary.

Study Design: Secondary analysis of cross-sectional survey data obtained from adults and children enrolled in 3 Medicaid health plans.