MEDICARE HMOs: A Funny Thing Happening in Pittsburgh, PA

      While last year's exodus of HMOs from "unprofitable" Medicare markets left 360,000 seniors nationwide scrambling to find health coverage, Pittsburgh area seniors are finding themselves with a choice among no fewer than nine Medicare HMOs operated by four insurers. The reason? Reimbursement rates in western Pennsylvania are among the highest in the country. The federal government spends $7,436 annually per senior in Allegheny County, compared to just $4,404 in "poorly compensated markets." Seniors in Pittsburgh are signing up for Medicare HMOs faster than their peers nationwide -- nearly 30% have enrolled, compared to 17% nationally -- because premiums range from nothing to $43 a month. In contrast, those who remain in traditional Medicare pay $91 to $166 for Medigap insurance. "This market has grown to a high penetration more quickly than any other in the country. Other markets took ten years to do what this market did in four short years," said Cynthia Hatcher, vice president of Medicare operations for Health America (Gaynor, Pittsburgh Post- Gazette, 3/29).