A comparison of S/HMO disenrollees and continuing members

Four Social/Health Maintenance Organization demonstration projects had disenrollment rates of about 8.6% annually during the first 36 months. This study compares those who disenrolled to those who remained S/HMO members. The analysis found that S/HMOs sponsored by HMOs had lower disenrollment than S/HMOs sponsored by long-term care organizations. The major reasons for disenrollment were dissatisfaction with physician services and premium costs. Having other insurance, not living alone, having inadequate information upon enrollment, having no physical impairments or health problems, and no use of hospital or chronic care were found to be positive predictors of disenrollment. Switching from the S/HMO to another HMO rather than to fee-for-service was associated with having no health problems, having no other health insurance, living alone, and being married.