Abstract
Objectives. We assessed the ability of managed care gatekeeping strategies (i.e., requiring a designated primary care provider to authorize referrals) to control health care costs in the mid-1990s. Methods. We analyzed expenditure data from 8195 privately insured adults sampled in the nationally representative 1996 Medical Expenditure Panel Survey. Managed care gatekeeping plan encollees included those in health maintenance organizations and other plans requiring a primary care gatekeeper. All others were considered indemnity plan enrollees. Results. In 1996, total per capita annual health expenditures for adult gatekeeping enrollees were about $50 less than those of indemnity enrollees, primarily owing to lower out-of-pocket expenditures. After multivariate adjustment, mean per capita expenditures were approximately 6% lower for gatekeeping enrollees than for indemnity enrollees. Conclusions. In the private sector, gatekeeping strategies resulted in modest cost savings over indemnity plans.
| Original language | English |
|---|---|
| Pages (from-to) | 286-291 |
| Number of pages | 6 |
| Journal | American Journal of Public Health |
| Volume | 95 |
| Issue number | 2 |
| DOIs | |
| State | Published - Feb 1 2005 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
Cite this
Health expenditures for privately insured adults enrolled in managed care gatekeeping vs indemnity plans. / Pati, Susmita; Shea, Steven; Rabinowitz, Daniel; Carrasquillo, Olveen.
In: American Journal of Public Health, Vol. 95, No. 2, 01.02.2005, p. 286-291.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Health expenditures for privately insured adults enrolled in managed care gatekeeping vs indemnity plans
AU - Pati, Susmita
AU - Shea, Steven
AU - Rabinowitz, Daniel
AU - Carrasquillo, Olveen
PY - 2005/2/1
Y1 - 2005/2/1
N2 - Objectives. We assessed the ability of managed care gatekeeping strategies (i.e., requiring a designated primary care provider to authorize referrals) to control health care costs in the mid-1990s. Methods. We analyzed expenditure data from 8195 privately insured adults sampled in the nationally representative 1996 Medical Expenditure Panel Survey. Managed care gatekeeping plan encollees included those in health maintenance organizations and other plans requiring a primary care gatekeeper. All others were considered indemnity plan enrollees. Results. In 1996, total per capita annual health expenditures for adult gatekeeping enrollees were about $50 less than those of indemnity enrollees, primarily owing to lower out-of-pocket expenditures. After multivariate adjustment, mean per capita expenditures were approximately 6% lower for gatekeeping enrollees than for indemnity enrollees. Conclusions. In the private sector, gatekeeping strategies resulted in modest cost savings over indemnity plans.
AB - Objectives. We assessed the ability of managed care gatekeeping strategies (i.e., requiring a designated primary care provider to authorize referrals) to control health care costs in the mid-1990s. Methods. We analyzed expenditure data from 8195 privately insured adults sampled in the nationally representative 1996 Medical Expenditure Panel Survey. Managed care gatekeeping plan encollees included those in health maintenance organizations and other plans requiring a primary care gatekeeper. All others were considered indemnity plan enrollees. Results. In 1996, total per capita annual health expenditures for adult gatekeeping enrollees were about $50 less than those of indemnity enrollees, primarily owing to lower out-of-pocket expenditures. After multivariate adjustment, mean per capita expenditures were approximately 6% lower for gatekeeping enrollees than for indemnity enrollees. Conclusions. In the private sector, gatekeeping strategies resulted in modest cost savings over indemnity plans.
UR - http://www.scopus.com/inward/record.url?scp=13144293046&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=13144293046&partnerID=8YFLogxK
U2 - 10.2105/AJPH.2002.013466
DO - 10.2105/AJPH.2002.013466
M3 - Article
C2 - 15671466
AN - SCOPUS:13144293046
VL - 95
SP - 286
EP - 291
JO - American Journal of Public Health
JF - American Journal of Public Health
SN - 0090-0036
IS - 2
ER -