Assessments of health plan performance by recent Medicare HMO enrollees: The role of primary care physician choice

This dissertation examines the role of primary care physician choice in Medicare beneficiaries' assessments of HMOs. Primary care physicians play an important role in delivering health care, and are assumed to help Medicare beneficiaries navigate the new environment of HMOs. The study uses data from a 1996 nationwide telephone survey of Medicare beneficiaries who recently enrolled in an HMO. Results from the study support the hypothesis that making a personal choice of primary care physician, and maintaining continuity of primary care when enrolling in an HMO are associated with increased use of preventive services and higher ratings of HMO performance. However, there was no statistically significant relationship between choice or continuity of primary care physician, and beneficiaries' perceptions of unmet health care needs. These findings have important implications for Medicare policy and delivery of health care in HMOs.