Some Elderly People Quit HMOs When Sick, Study Finds

Some elderly people on Medicare join HMOs when they are healthy, quit them when they fall sick and then join again after they get better, a study shows.

The researchers say this pattern means HMOs often avoid paying for seniors’ most expensive illnesses, and it undercuts a primary reason for promoting HMOs for the elderly: saving money.

Unlike people in ordinary HMOs, the elderly can quit Medicare HMOs with just a month’s notice.

“I don’t want to imply that everyone flips in and out. A lot of people go into HMOs and stay there. But there is also a lot of movement,” said Robert O. Morgan, a psychologist at the University of Miami and lead author of the study. The results are in today’s New England Journal of Medicine.

An industry trade group countered that turnover is actually small and that the overwhelming majority of the elderly stick with their HMOs in sickness and health.

Morgan’s analysis was based on a review of Medicare data from 1990 through 1993 on nearly 448,000 beneficiaries in southern Florida.