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Enter at Your Own Risk: HMO Participation and Enrollment in the MedicareRisk Market

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  • Jean Abraham
  • Ashish Arora
  • Martin Gaynor
  • Douglas Wholey

Abstract

We examine HMO participation and enrollment in the Medicare risk market for the years 1990 to 1995. We develop a profit- maximization model of HMO behavior, which explicitly considers potential linkages between an HMO's production decision in the commercial enrollee market and its participation and production decisions in the Medicare risk market. Our results suggest that the payment rate is a primary determinant of HMO participation, while the price of a supplemental Medicare insurance policy positively affects HMO Medicare enrollment. We also find empirical support for the existence of complementarities in the joint production of an HMO's commercial and Medicare products.

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Bibliographic Info

Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 7385.

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Date of creation: Oct 1999
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Publication status: published as Abraham, Jean, Ashish Arora, Martin Gaynor and Douglas Wholey. "Enter At Your Own Risk: HMO Participation And Enrollment In The Medicare Risk Market," Economic Inquiry, 2000, v38(3,Jul), 385-401.
Handle: RePEc:nbr:nberwo:7385

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  1. Pauly, Mark V, 1987. "Nonprofit Firms in Medical Markets," American Economic Review, American Economic Association, American Economic Association, vol. 77(2), pages 257-62, May.
  2. Douglas Staiger & James H. Stock, 1997. "Instrumental Variables Regression with Weak Instruments," Econometrica, Econometric Society, Econometric Society, vol. 65(3), pages 557-586, May.
  3. Wholey, Douglas & Feldman, Roger & Christianson, Jon B. & Engberg, John, 1996. "Scale and scope economies among health maintenance organizations," Journal of Health Economics, Elsevier, Elsevier, vol. 15(6), pages 657-684, December.
  4. Danzon, Patricia Munch, 1982. "Hospital `profits' : The effects of reimbursement policies," Journal of Health Economics, Elsevier, Elsevier, vol. 1(1), pages 29-52, May.
  5. Gourieroux Christian & Monfort Alain & Trognon A, 1981. "Pseudo maximum likelihood methods : theory," CEPREMAP Working Papers (Couverture Orange) 8129, CEPREMAP.
  6. Given, Ruth S., 1996. "Economies of scale and scope as an explanation of merger and output diversification activities in the health maintenance organization industry," Journal of Health Economics, Elsevier, Elsevier, vol. 15(6), pages 685-713, December.
  7. Wholey, Douglas & Feldman, Roger & Christianson, Jon B., 1995. "The effect of market structure on HMO premiums," Journal of Health Economics, Elsevier, Elsevier, vol. 14(1), pages 81-105, May.
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Cited by:
  1. Abe Dunn, 2010. "The Value of Coverage in the Medicare Advantage Insurance Market," BEA Working Papers, Bureau of Economic Analysis 0061, Bureau of Economic Analysis.

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