Medicare Managed Care:

HCFA Missing Opportunities to Provide Consumer Information

T-HEHS-97-109: Published: Apr 10, 1997. Publicly Released: Apr 10, 1997.

Additional Materials:


William J. Scanlon
(202) 512-7114


Office of Public Affairs
(202) 512-4800

GAO discussed: (1) Medicare beneficiaries' need for comparative information on health maintenance organizations (HMO); and (2) steps the Health Care Financing Administration (HCFA) could take to meet that need promptly.

GAO noted that: (1) HCFA does not distribute to beneficiaries comparative consumer guides such as those the federal government and many employer-based health insurance programs routinely distribute to their employees and retirees; (2) without these guides, beneficiaries cannot easily compare HMOs; (3) marketing materials distributed by HMOs are of little help because HMOs describe their benefits and costs using different terms and formats; (4) although beneficiaries lack information on HMOs, HCFA does not; (5) HCFA amasses volumes of information that could be summarized, packaged, and distributed to help beneficiaries choose among competing Medicare HMOs; (6) for example, HCFA compiles information that can be used to construct HMO benefit comparison charts; (7) HCFA also routinely collects other information, such as disenrollment rates, beneficiary complaints about HMOs, and the results of HCFA's HMO monitoring visits, that could be provided to beneficiaries; (8) because some plans do a better job of retaining Medicare beneficiaries than others, disenrollment rates, an indicator of beneficiary satisfaction, may be especially useful in helping beneficiaries distinguish among competing HMOs; (9) for example, GAO's analysis of HCFA's data showed that 1995 annual disenrollment rates ranged from 4 to 42 percent among Los Angeles HMOs and from 12 to 37 percent among Miami HMOs; (10) HCFA has initiatives, planned or under way, that will make some comparative HMO information available to beneficiaries; (11) although these initiatives are steps in the right direction, they are very small steps; and (12) with little additional time and effort, HCFA could do much more to help Medicare beneficiaries make informed selections among available HMOs.

Oct 18, 2017

Oct 4, 2017

Oct 3, 2017

Sep 29, 2017

Sep 13, 2017

Sep 12, 2017

Sep 8, 2017

Sep 7, 2017

Looking for more? Browse all our products here