Journal article
The Federal Employees Health Benefits Program: Model for Competition in Rural America?
The Journal of rural health, Vol.21(2), pp.105-113
03/2005
DOI: 10.1111/j.1748-0361.2005.tb00070.x
PMID: 15859047
Abstract
Context: The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) created the Medicare Advantage (MA) program, which promotes the entry of private Preferred Provider Organization (PPO) plans into regions that have not previously had Medicare managed care plans. The assumption that a competitive environment will develop is based on experiences in the Federal Employees Health Benefits Program (FEHBP). Purpose: The authors test the hypothesis that the FEHBP has fostered an environment of competing health plans, especially preferred provider organizations (PPOs), in rural areas. Methods: Data from the US Office of Personnel Management are used to quantify the number of FEHBB-certified plans in each US county and the number of enrollees in each plan. Data from the Area Resource File are used to measure independent variables in multivariate analysis to account for the number of FEHBP-certified health plans competing in each US county. Findings: While 98% of all counties have at least 3 plans with enrollment, in many sparsely populated rural areas, only 1 of the plans is an open-enrollment plan (excludes plans for letter carriers). There is a strong relationship between the number of FEHBP plans and areas with high population counts and high population density. In many counties with low population counts (under 3,000), most PPOs are not contracting with the nearest primary care provider. Conclusions: The FEHBP is not a perfect predictor of MA plan activity because the MA program does not use the FEHBP approach of certifying regional plans that must offer local access. However, the FEHBP experience indicates that plans are attracted to areas with high population counts and high population density.
Details
- Title: Subtitle
- The Federal Employees Health Benefits Program: Model for Competition in Rural America?
- Creators
- Keith J Mueller - Department of Preventive and Societal Medicine, University of Nebraska Medical Center, Omaha, NebrTimothy D McBride - RUPRI Center for Rural Health Policy Analysis, University of Nebraska Medical Center, Omaha, NebrCourtney Andrews - RUPRI Center for Rural Health Policy Analysis, University of Nebraska Medical Center, Omaha, NebrRoslyn Fraser - RUPRI Center for Rural Health Policy Analysis, University of Nebraska Medical Center, Omaha, NebrLiyan Xu - RUPRI Center for Rural Health Policy Analysis, University of Nebraska Medical Center, Omaha, Nebr
- Resource Type
- Journal article
- Publication Details
- The Journal of rural health, Vol.21(2), pp.105-113
- Publisher
- Blackwell Publishing Ltd
- DOI
- 10.1111/j.1748-0361.2005.tb00070.x
- PMID
- 15859047
- ISSN
- 0890-765X
- eISSN
- 1748-0361
- Number of pages
- 9
- Language
- English
- Date published
- 03/2005
- Academic Unit
- Health Management and Policy; Public Policy Center (Archive)
- Record Identifier
- 9984214833702771
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