HMO ENROLLMENT: Up Significantly Across State, Despite Complaints
Despite much public "grumbling," Californians are continuing to sign up with HMOs at record rates, the Sacramento Business Journal reports. Between March 1998 and March 1999, statewide HMO enrollment rose 6.4%, according to Burlingame-based health care consultants Cattaneo & Stroud, based on data from the state Department of Health Services, HCFA and health plans in the state. Commercial HMO enrollment grew by 2.4%, and Medi-Cal HMOs were up "a whopping 36.5% as the state moved ahead with an initiative to require low-income residents in selected counties to sign up with managed care plans." And despite several large HMOs' decisions to drop Medicare managed care business in 11 counties, overall enrollment in Medicare HMOs across the state was up 2.3%. Grant Cattaneo, "the consultant who crunched the numbers," said, "The numbers this year surprised me because enrollment grew a hair faster than the population itself." Five health plans -- Kaiser Permanente, Health Net, PacifiCare, Blue Cross, and Blue Shield -- control 74.3% of the total HMO market and 79% of commercial plans, leaving 39 other plans to compete for the other "quarter of the pie." Kaiser alone boasts 33% of the total HMO market, with 39.2% of the commercial market and 33.9% of the Medicare sector.
Too Good to Last?
Several experts predict the trend is sure to slow in coming months, trailing a rash of recently announced year 2000 premium hikes. Sacramento-based health care consultant Albert Lowey-Ball said, "My guess is there will be some erosion in HMO enrollment next year -- and even more the year after. The potential for pulling out is probably greatest among small employers and individuals, those most affected by higher rates." But Walter Zelman, president of the California Association of Health Plans, disagreed, saying that premiums are actually rising more slowly in managed care than in other health care sectors less able to control their costs. He said, "People realize that while managed care needs to improve, health plans are an extraordinary value. They offer high-quality care at an affordable cost -- and enrollment keeps going up largely for that reason" (Robertson, 7/19 issue).