After Recruiting Elderly, Many HMOs Now Retreat

By David J. Morrow N. Y. Times News Service | THE JOURNAL RECORD, September 23, 1998 | Go to article overview

After Recruiting Elderly, Many HMOs Now Retreat


David J. Morrow N. Y. Times News Service, THE JOURNAL RECORD


Like thousands of other elderly Americans, Eugene DeLorenzo of Chico, Calif., cannot find a Medicare health maintenance organization in his area.

DeLorenzo, a 75-year-old retired real estate broker and his wife, Yuriko, enrolled July 1 in the Medicare plan of Health Net, a unit of Foundation Health Systems. Just three weeks later, Health Net -- unable to make a strong profit in Butte County, the rural northern county where DeLorenzo lives -- said it was ending its coverage there.

"My first thought was, `Well, what are we going to do now?'" DeLorenzo recalled. "It wasn't going to do any good to get angry. That's just the way these HMOs operate."

With few options, the DeLorenzos enrolled in traditional fee-for- service Medicare, the federally financed health care plan for the disabled and people 65 or older. They may also have to pay hundreds of dollars more in premiums for a supplemental policy to replace the generous benefits Health Net had offered.

People like the DeLorenzos are fast becoming common statistics. After aggressively recruiting the elderly and the disabled into their Medicare plans, many of the nation's HMOs are now heavily retreating.

United Healthcare, once a darling of Wall Street, recently took a $900 million charge against earnings, in part to scale back its Medicare operations in 35 counties. In the last year, Aetna, Pacificare Health Systems, Oxford Health Plans, Foundation Health Systems, Kaiser Permanente and Blue Cross and Blue Shield associations have canceled Medicare plans in parts of 13 states. Virtually no Medicare HMOs are available in Utah or in rural Ohio.

With Medicare costs escalating wildly, Congress has long looked to managed-care plans as the prime remedy. Introduced in 1985 to allow private insurers to cover the elderly, Medicare HMOs provide health care more cheaply than the government does. They also tend to offer more benefits to consumers and reduce the amount of claims paperwork.

Despite the HMO problems in the Medicare market, Washington is now pushing for even more people to enroll in the plans. Yet financial setbacks for some HMOs have raised serious questions as to whether they can prosper covering Medicare patients.

Though critics of managed care are quick to say they cannot, analysts say that several HMOs -- namely Humana and Pacificare, two of the nation's largest Medicare providers -- are making money on their plans, at least for now. But even these companies have had to make adjustments.

"There are a few HMOs that can be successful with Medicare, and they should prosper," said Kenneth Abramowitz, a health care analyst with Sanford C. Bernstein & Co. …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

After Recruiting Elderly, Many HMOs Now Retreat
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.