Private Payers Serving Individuals with Disabilities and Chronic Conditions. C. Methods for this Study



The data for this study come from claims and enrollment files from two large employers for years 1994 and 1995. To remind the reader, Employer A is a private sector employer with over 30 locations across the United States, where each location offers the same indemnity plan and a POS managed care plan. Employer B is a large state government employer which offers an indemnity plan, a preferred provider organization (PPO) plan, and seven health maintenance organization (HMO) plans. A description of the features and costs of each plan is given in Chapter 2.

For this risk-adjustment study, the sample from Employer A was limited to employees age 18 to 65; data on dependents were not available. The POS plan was not offered in 1994, so the data for Employer A come from the indemnity plan only. The total sample included 68,904 employees. The sample used to estimate the models for Employer B consisted of 171,644 employees, dependents, and retirees under age 65.

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