Table 1.
Characteristics of Medicare Advantage Plans Participating in the 2006 to 2007 Medicare Health Outcomes Survey
| Plan Characteristic | Plans Reporting to HEDIS in 2006–2007 (n = 172), n (%) | Plans Not Reporting to HEDIS (n = 31), n (%) |
|---|---|---|
| Profit status | ||
|
| ||
| For-profit | 119 (69.2) | 17 (62.1) |
|
| ||
| Nonprofit | 53 (30.8) | 11 (37.9) |
| Model type | ||
|
| ||
| Nonstaff/nongroup | 143 (86.1) | 29 (96.7) |
|
| ||
| Staff/group | 23 (13.9) | 1 (3.3) |
| Time participating in Medicare | ||
|
| ||
| ≤5 y | 46 (26.7) | 12 (38.7) |
|
| ||
| 5–10 y | 48 (27.9) | 6 (19.4) |
|
| ||
| >10 y | 78 (45.4) | 13 (41.9) |
|
| ||
| Beneficiaries | ||
| <4845 | 33 (19.2) | 20 (64.5) |
|
| ||
| 4845–16 295 | 44 (25.6) | 6 (19.4) |
|
| ||
| 16 296–32 390 | 48 (27.9) | 2 (6.4) |
|
| ||
| >32 390 | 47 (27.3) | 3 (9.7) |
|
| ||
| State Medicare Advantage market penetration | ||
| <10% | 28 (16.3) | 7 (22.6) |
|
| ||
| 10–25% | 94 (54.6) | 16 (51.6) |
|
| ||
| >25% | 50 (29.1) | 8 (25.8) |
| Census division | ||
|
| ||
| New England | 7 (4.1) | 3 (9.7) |
|
| ||
| Middle Atlantic | 39 (22.7) | 4 (12.9) |
|
| ||
| East North Central | 27 (15.7) | 4 (12.9) |
|
| ||
| West North Central | 15 (8.7) | 5 (16.1) |
|
| ||
| South Atlantic | 24 (14.0) | 4 (12.9) |
|
| ||
| East South Central | 8 (4.6) | 4 (12.9) |
|
| ||
| West South Central | 10 (5.8) | 0 (0.0) |
|
| ||
| Mountain | 18 (10.5) | 2 (6.4) |
|
| ||
| Pacific | 20 (11.6) | 5 (16.1) |
|
| ||
| Puerto Rico | 4 (2.3) | 0 (0.0) |
| Plans overreporting rates of high-risk prescribing | ||
|
| ||
| <1.00% | 4 (2.3) | NA |
|
| ||
| ≥1.00% | 4 (2.3) | NA |
| Plans underreporting rates of high-risk prescribing | ||
|
| ||
| <1.00% | 5 (2.9) | NA |
|
| ||
| 1.00%–4.99% | 57 (33.1) | NA |
|
| ||
| 5.00–9.99% | 85 (49.5) | NA |
|
| ||
| ≥10.00% | 17 (9.9) | NA |
HEDIS = Healthcare Effectiveness Data and Information Set; NA = not applicable.