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Enrollee mix, treatment intensity, and cost in competing indemnity and HMO plans
2003
Journal of Health Economics
Why do indemnity insurance plans cost substantially more per capita-77% more in our studythan HMOs? We answer this question using data from a large organization's insurance pool, covering 215,000 lives. We decompose cost differences for eight major medical conditions into four sources: demographics, incidence within demographic groups, treatment intensity, and prices per service. Greater incidence of disease in the indemnity plan (both from demographics themselves and within demographic groups)
doi:10.1016/s0167-6296(02)00094-2
pmid:12564716
fatcat:2okfztnhpfespklbqkmalgodxe