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175. Health Maintenance Organizations (HMOs)
[As of January 1, except as noted (9.1 represents 9,100,000).An HMO is a prepaid health plan delivering comprehensive care to membersthrough designated providers, having a fixed
periodic payment for healthcare services, and requiring members to be in a plan for a specified period of time (usually 1 year). A group HMO delivers health servicesthrough a
physician group that is controlled by the HMO unit or contractswith one or more independent group practices to provide health services.An individual practice association (IPA) HMO
contracts directly with physiciansin independent practice, and/or contracts with one or more associationsof physicians in independent practice, and/or contracts with one or
moremultispecialty group practices. Data are based on a census of HMO's.NORTHEAST: Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, Connecticut, New York, New Jersey, and
Pennsylvania.MIDWEST: Ohio, Indiana, Illinois, Michigan, Wisconsin, Minnesota, Iowa, Missouri, North Dakota, South Dakota, Nebraska, and Kansas.SOUTH: Delaware, Maryland, District of
Columbia, Virginia, West Virginia, North Carolina, South Carolina, Georgia, Florida, Kentucky, Tennessee, Alabama, Mississippi, Arkansas, Louisiana, Oklahoma, and Texas.WEST: Montana,
Idaho, Wyoming, Colorado, New Mexico, Arizona, Utah, Nevada, Washington, Oregon, California, Alaska, and Hawaii]
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NUMBER OF PLANS
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NUMBER OF PLANS
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NUMBER OF PLANS
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ENROLLMENT (mil.)
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ENROLLMENT (mil.)
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ENROLLMENT (mil.)
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Model type
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MODEL TYPE
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1980 1
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1985
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1990
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1991
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1992
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1993
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1994
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1995
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1996
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1997
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1998
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1999
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1980
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1985
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1990
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1991
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1992
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1993
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1994
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1995
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1996
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1997
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1998
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1999
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(June 30)
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(Dec. 31)
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(June 30)
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(Dec. 31)
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Total
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235
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478
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572
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553
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555
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551
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540
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550
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628
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651
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651
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643
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Total
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9.1
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21.0
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33.0
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34.0
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36.1
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38.4
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42.2
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46.2
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52.5
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58.8
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64.8
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81.3
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Model type:
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Model type:
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I.P.A
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97
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244
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360
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346
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340
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332
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319
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323
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366
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284
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317
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309
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I.P.A
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1.7
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6.4
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13.7
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13.6
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14.7
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15.3
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16.1
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17.4
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21.7
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21.0
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24.8
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32.8
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Group
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138
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234
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212
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168
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166
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150
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117
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107
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122
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109
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122
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126
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Group
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7.4
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14.6
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19.3
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17.1
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16.5
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15.4
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13.6
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12.9
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13.5
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10.8
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13.1
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15.9
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Mixed
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(NA)
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(NA)
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(NA)
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39
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49
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69
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104
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120
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140
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258
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212
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208
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Mixed
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(NA)
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(NA)
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(NA)
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3.3
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4.9
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7.7
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12.5
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15.9
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17.2
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27.0
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26.9
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32.6
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Region:
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Northeast
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55
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81
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115
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116
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111
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102
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101
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99
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111
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110
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107
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110
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Federal program: 2
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Midwest
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72
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157
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160
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157
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165
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169
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159
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154
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181
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184
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185
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179
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Medicaid
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0.3
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0.6
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3
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1.2
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1.4
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1.7
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1.7
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2.6
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3.5
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4.7
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5.5
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7.8
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10.4
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South
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45
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141
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176
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163
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161
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167
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173
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190
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217
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236
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237
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239
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Medicare
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0.4
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1.1
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1.8
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2.0
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2.2
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2.2
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2.5
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2.9
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3.7
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4.8
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5.7
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6.5
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West
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63
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99
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121
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117
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118
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113
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107
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107
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119
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121
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122
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115
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NA Not available.
1 1980-98 excludes enrollees participating in open-ended plans; 1999, includes open-ended enrollment.nn
2 Refers to enrollment by medicaid or medicare beneficiaries, where theprogram contracts directly with the HMO to pay the appropriate annualpremium.
3 Enrollment for 1990 as of June 30.
Source: InterStudy Publications, St. Paul, MN,The InterStudy Competitive Edge, annual (copyright).
http://www.hmodata.com/
https://allcountries.org/uscensus/175_health_maintenance_organizations_hmos.html
These tables are based on figures supplied by the United States Census Bureau, U.S. Department of Commerce and are subject to revision by the Census Bureau.
Copyright © 2019 Photius Coutsoukis and Information Technology Associates, all rights reserved.
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