Table 1 Enrollee and Benefit Characteristics in Intervention and Control Plans
From: Association of daily copayments with use of hospital care among medicare advantage enrollees
Variable | Intervention Plans | Control Plans | All Plans | ||
|---|---|---|---|---|---|
Year before deductible to per diem change | Year after deductible to per diem change | Year before intervention plans changed benefit | Year after intervention plans changed benefit | Yearly Average 2007 to 2010 | |
Enrollee Characteristics | |||||
Enrollees | 182,452 | 216,549 | 267,774 | 291,546 | 4,261,061 |
Hospitalized Enrollees | 26,731 | 30,356 | 38,353 | 43,350 | 664,112 |
Age – yr | 75.3 (6.9) | 75.0 (7.0) | 75.6 (6.8) | 75.6 (7.0) | 74.4 (7.0) |
Female sex – % | 53.8 | 53.5 | 53.5 | 53.1 | 51.9 |
Race – % | |||||
White | 89.3 | 89.3 | 90.4 | 90.4 | 84.7 |
Black | 5.8 | 5.8 | 4.0 | 4.0 | 8.8 |
Other | 5.0 | 5.0 | 5.6 | 5.6 | 6.6 |
Part D subsidy – % | 4.1 | 4.2 | 4.6 | 4.5 | 5.4 |
Benefit Characteristics | |||||
Number of Plans | 23 | 23 | 42 | 42 | 1975 |
Average star rating | 2.9 | 2.6 | 2.8 | 2.9 | 2.9 |
Average # of Enrollees | 7933 | 9415 | 6376 | 6942 | 2157 |
Plan Type | |||||
HMO | 91.3 | 91.3 | 69.0 | 69.0 | 53.0 |
PPO | 8.7 | 8.7 | 26.2 | 26.2 | 22.4 |
PFFS | 0.0 | 0.0 | 2.4 | 2.4 | 17.0 |
Other | 0.0 | 0.0 | 2.4 | 2.4 | 7.6 |
Mean deductible – $ | $376 | $349 | $349 | $412 | |
Mean per diem (days 1–5) – $ | $165 | $161 | |||
Mean PCP copayment – $ | $11 | $13 | $13 | $12 | $14 |
Mean Spec. copayment – $ | $21 | $25 | $21 | $21 | $25 |
Mean emergency department copayment – $ | $50 | $50 | $49 | $49 | $49 |
Zero premium plans – % | 65.2 | 60.9 | 45.2 | 45.2 | 58.5 |
Mean plan premium amount A/B – $ | $20 | $18 | $31 | $31 | $24 |
SNF requires prior hospital stay – % of plans | 0.0 | 0.0 | 14.3 | 14.3 | 10.1 |
SNF benefits include cost sharing for first 20 days of SNF stay – % of plans | |||||
Coinsurance | 0.0 | 0.0 | 0.0 | 0.0 | 14.7 |
Deductible | 0.0 | 0.0 | 0.0 | 0.0 | 1.2 |
Copayment | 100.0 | 100.0 | 92.9 | 92.9 | 45.0 |