Supplementary Table 1
The Medicare+Choice (M+C) Program in the 12 HSC Study Sites.

This table shows how the monthly payment rates to Medicare+Choice (M+C) plans, plan participation in M+C, and the types of plans participating in M+C have changed from 1996 to 2001 in the twelve HSC study sites. With the exception of those sites that received larger year-over-year payment increases due to an increase in the "floor" payment, payment rates have grown at a slow 2 percent rate (3 percent in 2001). Meanwhile, health plan participation in M+C declined in ten of the 12 HSC study sites from 1998 to 2001 (and plan participation in the other two sites, Little Rock and Greenville, held steady at one and zero plans, respectively). Furthermore, much of this decline was driven by multi-state plans: multi-state plan participation in M+C declined from 1996 to 2001 in eight of the nine sites that had such plans in 1996. These trends are a clear departure from the trend from 1996 to 1998, when plan participation increased in half of the sites.  


 
Monthly Payment Rate1
Number of Plans with Enrollment2,3
Types of Plans in Market 3,4
Degree of M+C Penetration/Site
1996
1998
2000
20015
2002
1996
1998
2000
2001
1996
2001
High Penetration                      
Orange Co.
Phoenix
Miami
$545
472
687
$584
499
763
$610
524
794
$628
540
818
$640
553
834
14
8
9
12
9
10
11
7
11
8
7
8
7M, 2B, 5L
4M, 1B, 3L
5M, 1B, 3L
4M, 2B, 2L
5M, 2L
2M, 1B, 5L
Moderate Penetration                      
Seattle
Boston
Cleveland
$410
532
516
$437
581
553
$483
604
576
$525
622
593
$553
635
605
6
7
7
5
6
10
6
6
8
2
5
7
2M, 1B, 3L
2M, 1B, 4L
4M, 1B, 2L
1M, 1L
1B, 4L
2M, 1B, 4L
Limited Penetration                      
Lansing
Little Rock
Northern N.J.
$477
444
518
$500
477
554
$520
498
579
$535
525
596
$553
553
608
1
2
5
1
3
8
1
1
6
1
1
3
1B
1M, 1B
3M, 1B, 1L
1B
1B
2M, 1B
Minimal Penetration                      
Indianapolis
Greenville
Syracuse
$456
327
368
$486
367
375
$506
405
418
$525
525
525
$553
553
553
3
1
0
3
0
1
4
0
1
2
0
0
1M, 1B, 1L
1B
—
2L
—
—

Source: Centers for Medicare and Medicaid Services
1 Payment rate is for largest county in each site. For comparison, national per capita spending on enrollees in Coordinated Care Plans (CCPs) contract plans are as follows: 1996 - $436; 1998 - $468; 2000 - $500; 2001 - $539; 2002 - $570. National spending estimates are for December for 1996-2001 and for January for 2002.
2 Includes CCP plans and Cost and Demo contract plans if their enrollment is greater than 1,000 Medicare eligibles and excludes Private Fee-For-Service (PFFS) plans.
3 Data are for December of each year.
4 M=multi-state; B=Blue Cross/Blue Shield; L=locally-based
5 Represents the payment rates that were in effect for March - December of 2001.

These results are linked to the analysis in Grossman, Joy M., Bradley C. Strunk and Robert E. Hurley, "Reversal of Fortune: Medicare+Choice Collides with Market Forces," Issue Brief No. 52, Center for Studying Health System Change, Washington, D.C. (May 2002).