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Disenrollment Patterns Of Elderly In Managed Care And Fee For Service, Kenneth G. Manton, Dennis H. Tolley, Robert Newcomer, James C. Vertrees, Charlene Harrington

Journal of Actuarial Practice (1993-2006)

As the trend to provide health care through managed care facilities increases, the need to examine ,vhy insured individuals voluntarily terminate managed care coverage grows. Voluntary termination of coverage, or dis enrollment, has both social and fiscal implications. Particularly among the elderly, patterns of disenrollment likely are related to self assessment of care needs and levels of health. In this paper we examine the patterns of dis enrollment among elderly enrollees as a function of health status and disability. We focus on disenrollment patterns from an experimental prepaid extended care facility, called a social HMO (S/HMO) and compare this pattern …