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Who Switches from Medigap to Medicare HMOs? (Health Services Research)

Publication Topics

Medicare; Health Insurance Coverage and Programs

Publication Type

Journal Article

Publication Date


Author 1

<a onclick="OpenPopUpPage('{7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=354&RootFolder=*', RefreshPage); return false;" href="{7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=354&RootFolder=*">Thomas Rice, Ph.D.</a>

Author 2

<a onclick="OpenPopUpPage('{7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=14&RootFolder=*', RefreshPage); return false;" href="{7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=14&RootFolder=*">Rani E. Snyder</a>

Author 3

<a onclick="OpenPopUpPage('{7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=144&RootFolder=*', RefreshPage); return false;" href="{7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=144&RootFolder=*">Gerald F. Kominski, PhD</a>

Author 4

<a onclick="OpenPopUpPage('{7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=94&RootFolder=*', RefreshPage); return false;" href="{7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=94&RootFolder=*">Nadereh Pourat, PhD</a>

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Objective. To determine the factors affecting whether Medigap owners switch to Medicare managed care plans.

Data Sources. The primary data were the 1993–1996 Medicare Current Beneficiary Survey (MCBS) Cost and Use Files. These were supplemented by data available from the Centers for Medicare & Medicaid Services (CMS) website.

Study Design. Individuals on the MCBS files with Medigap coverage in the period 1993–1996 were included in the study. The person-year was the unit of analysis. The authors used multivariate logistic regression analysis to determine whether or not a Medigap owner switched to a Medicare-managed care plan during a particular year. Independent variables included measures of affordability, need for services, health insurance benefits, sociodemographics, and supply of managed care plans.

Principal Findings. The authors did not detect strong evidence that beneficiaries in poorer health were more likely than others to switch from Medigap coverage to Medicare-managed care. In addition, higher Medigap premiums did not appear to induce beneficiaries to switch into managed care.

Conclusions. The authors examined selection bias in joining managed care plans among the subset of Medicare beneficiaries who have Medigap policies. No strong evidence of selection bias was found in this population. They concluded that there was no evidence that the Medigap market is becoming prohibitively expensive as a result of unfavorable selection.

Rice T, Synder RE, Kominski GF, Pourat N. Who Switches from Medigap to Medicare HMOs? Health Services Research. 37(2): 273-290, April 2002.


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Version: 3.0
Created at 9/27/2011 11:58 AM by Harout Katerjian
Last modified at 1/10/2013 4:10 PM by i:0#.f|uclachissqlmembershipprovider|jonathan