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Results for “Insurance Selection Bias”

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PubMed2003

Patient selection in the ESRD managed care demonstration.

The Centers for Medicare & Medicaid Service's (CMS') end stage renal disease (ESRD) managed care demonstration offered an opportunity to assess patient selection among a chronically ill and inherently costly population. Patient selection refers to the phenomenon whereby those Medicare beneficiaries who choose to enroll or stay in health maintenance organizations (HMOs) are, on average, younger, healthier, and less costly to treat than beneficiaries who remain in the traditional Medicare fee-for-service (FFS) sector. The results presented in this article show that enrollees into the demonstration were generally younger and healthier than a representative group of comparison patients from the same geographic areas.

Adult↗
PubMed1992

Consumer competence and the reform of American health care.

This report examines the role of the expert in the American health care system, both as provider and administrative policymaker. It shows that the guiding assumption of American health care policy, ie, that the medical system can and should be managed by experts on behalf of consumers and patients, does not hold up to scrutiny. It also demonstrates that the important theme in American history of placing authority and responsibility for action in the hands of the individual has not been sufficiently influential in American health care. Drawing on this theme and creating consumer competence and responsibility in health care choices as the keys to health care reform in the United States are advocated.

Adult↗