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Related Experiment Videos

Managed care and employer premiums.

Michael A Morrisey1, Gail A Jensen, Jon Gabel

  • 1Lister Hill Center for Health Policy, University of Alabama, Birmingham, 1665 University Blvd-Suite 330, Birmingham, AL 35294-0022, USA. Morrisey@uab.edu

International Journal of Health Care Finance and Economics
|November 25, 2003
PubMed
Summary

Market-wide managed care penetration did not significantly impact overall employer health insurance premiums. However, higher Health Maintenance Organization (HMO) penetration lowered HMO costs while increasing conventional and Preferred Provider Organization (PPO) plan costs.

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Area of Science:

  • Health Economics
  • Healthcare Management
  • Insurance Markets

Background:

  • Employer-sponsored health insurance is a significant component of employee compensation.
  • Managed care strategies have been implemented to control healthcare costs.
  • The impact of managed care penetration on insurance premiums warrants detailed investigation.

Purpose of the Study:

  • To analyze the relationship between market-wide managed care penetration and employer-sponsored health insurance premiums.
  • To differentiate the effects of managed care penetration across various plan types (conventional, HMO, PPO).
  • To explore how firm self-insurance status moderates these effects.

Main Methods:

  • Utilized data from medium and large employers spanning 1993-1997.

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  • Employed regression analysis to assess premiums for single coverage.
  • Examined weighted average premiums, as well as conventional, HMO, and PPO specific premiums.

    • Main Results:

    • No statistically significant effect of managed care penetration on overall weighted average employer premiums was found.
    • Increased Health Maintenance Organization (HMO) penetration correlated with lower HMO premiums but higher conventional and Preferred Provider Organization (PPO) premiums.
    • Higher PPO penetration showed no significant impact across different plan types.
    • The influence of HMO penetration on premiums varied based on whether firms offered self-insured plans.

    Conclusions:

    • Market-wide managed care penetration's effect on average employer premiums is not statistically significant.
    • HMOs appear to influence premium dynamics for competing plan types, especially in self-insured environments.
    • The findings highlight the complex interplay between managed care strategies, plan types, and employer financing structures.