HMO Satisfaction and Understanding Among Recent Medicare Enrollees

Abstract

HMO enrollment is growing substantially, with particular interest in stimulating Medicare enrollment. The outcomes of this relatively novel form of health care for older persons are unclear, however. A survey of 124 recent enrollees in HMO Medicare coverage assessed their experiences as a follow-up to a study of their enrollment decision. Satisfaction with various dimensions of care and coverage is high, reflecting fulfillment of high expectations held at enrollment. Perceived understanding of HMO coverage and procedures is the best predictor of satisfaction. Informal ties appear to play an important role in providing orientation to the HMO model of care and coverage, echoing their role in the enrollment decision itself. The importance of understanding and lay referral is highlighted from the standpoint of a consumerist orientation to health care. The medical marketplace is becoming increasingly differentiated, and offers new forms of delivery and coverage such as health maintenance organizations, preferred provider organizations, free-standing urgent care centers, ambulatory surgical centers, and home health care (Altman