Why are managed care plans less expensive : risk selection, utilization, or reimbursement?

<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.loc.gov/MARC21/slim http://www.loc.gov/standards/marcxml/schema/MARC21slim.xsd">
  <record>
    <leader>00000nab a2200000 i 4500</leader>
    <controlfield tag="001">MAP20071505330</controlfield>
    <controlfield tag="003">MAP</controlfield>
    <controlfield tag="005">20080418124607.0</controlfield>
    <controlfield tag="007">hzruuu---uuuu</controlfield>
    <controlfield tag="008">040524e20040301usa||||    | |00010|eng d</controlfield>
    <datafield tag="040" ind1=" " ind2=" ">
      <subfield code="a">MAP</subfield>
      <subfield code="b">spa</subfield>
    </datafield>
    <datafield tag="084" ind1=" " ind2=" ">
      <subfield code="a">42</subfield>
    </datafield>
    <datafield tag="100" ind1="1" ind2=" ">
      <subfield code="0">MAPA20080112066</subfield>
      <subfield code="a">Polsky, Daniel</subfield>
    </datafield>
    <datafield tag="245" ind1="1" ind2="0">
      <subfield code="a">Why are managed care plans less expensive</subfield>
      <subfield code="b">: risk selection, utilization, or reimbursement?</subfield>
      <subfield code="c">Daniel Polsky, Sean Nicholson</subfield>
    </datafield>
    <datafield tag="520" ind1="8" ind2=" ">
      <subfield code="a">This article develops a new method of decomposing the cost difference between HOM and non HMO plans into observed risk selection, unobserved risk selection, utilization differences, and differences in provider reimbursement rates. We implement this method  using a large national sample of employers-sponsored health insurance enrollees from the Community Tracking Study Household Survey. We find no evidence that HMO plans attract a disproportionate share of low-risk medical expenditures per enrollee can be explained by the relatively low provider reimbursement rates paid by HMO plans. This indicates there may be little need for employers to risk adjust insurance premiums or otherwise restrict employee choice of plans types</subfield>
    </datafield>
    <datafield tag="650" ind1="1" ind2="1">
      <subfield code="0">MAPA20080553258</subfield>
      <subfield code="a">Asistencia</subfield>
    </datafield>
    <datafield tag="650" ind1="1" ind2="1">
      <subfield code="0">MAPA20080598983</subfield>
      <subfield code="a">Seguro de enfermedad</subfield>
    </datafield>
    <datafield tag="650" ind1="1" ind2="1">
      <subfield code="0">MAPA20080592844</subfield>
      <subfield code="a">Programas estatales</subfield>
    </datafield>
    <datafield tag="650" ind1="1" ind2="1">
      <subfield code="0">MAPA20080568863</subfield>
      <subfield code="a">Estados Unidos</subfield>
    </datafield>
    <datafield tag="700" ind1="1" ind2=" ">
      <subfield code="0">MAPA20080142537</subfield>
      <subfield code="a">Nicholson, Sean</subfield>
    </datafield>
    <datafield tag="740" ind1="4" ind2=" ">
      <subfield code="a">The Journal of risk and insurance</subfield>
    </datafield>
    <datafield tag="773" ind1="0" ind2=" ">
      <subfield code="t">The Journal of risk and insurance</subfield>
      <subfield code="d">Orlando</subfield>
      <subfield code="g">Volume 71, number 1, March 2004 ;  p. 21-40</subfield>
    </datafield>
  </record>
</collection>