Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 1987 Winter;9(2):55-63.

Selection bias in health maintenance organizations: analysis of recent evidence

Selection bias in health maintenance organizations: analysis of recent evidence

F J Hellinger. Health Care Financ Rev. 1987 Winter.

Abstract

An analysis of recent research regarding selection bias in health maintenance organizations (HMO's) is presented in this article. Review of the available literature leads one to conclude that prepaid group practice HMO's do experience favorable selection. It has been demonstrated in numerous studies that prior use of health services by HMO enrollees is less than prior use of health services by those who remain in the fee-for-service sector, and there is considerable evidence that shows a statistically significant positive relationship between prior use and current use. This is true for both those under 65 years of age and those 65 years of age or over.

PubMed Disclaimer

References

    1. American Hospital Association. HHS to expand prepaid health plans. AHA News. 1987 Jan.23(2):1.
    1. Andersen G, Knickman JR. Patterns of expenditures among high utilizers of medical care services: The experience of Medicare beneficiaries from 1974 to 1977. Medical Care. 1984;22:143. - PubMed
    1. Anderson J, Resnick L, Gertman P. Prediction of Subsequent Year Reimbursement Using the Medicare History File. Boston: Boston University Medical Center, Health Policy Consortium; Jan. 1982.
    1. Buchanan J, Cretin S. Risk selection of families electing HMO membership. Medical Care. 1986 Jan.24(1):39–51. - PubMed
    1. Densen P, Shapiro S, Einhorn M. Concerning high and low utilizers of a service in a medical care plan, and the persistence of utilization levels over a three-year period. Milbank Memorial Fund Quarterly. 1959;37:37. - PubMed

LinkOut - more resources