Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: FRIDAY, April 21, 1995                   TAG: 9504210105
SECTION: NATIONAL/INTERNATIONAL                    PAGE: SA5/INTL   EDITION: METRO 
SOURCE: ASSOCIATED PRESS
DATELINE: WASHINGTON                                 LENGTH: Medium

STUDY SAYS HMOS WORK EQUALLY WELL

The study, published Thursday in the journal Health Affairs, examined the insurance arrangements and health status of more than 60,000 Americans surveyed in 1992 by the National Center for Health Statistics.

Almost 41,000 had private, indemnity insurance that allowed free choice of doctors and hospitals, while 19,575 were in HMOs that provided prepaid care at fixed rates and restricted which physicians and facilities their patients could go to.

A previous study of elderly Medicare patients enrolled in HMOs found that these prepaid plans tended to attract healthier seniors with fewer problems than others their age, the vast majority of whom get fee-for-service coverage.

The researchers in the new study, whose work was funded by the Robert Wood Johnson Foundation, looked at people under 65 with private insurance who suffered from 15 chronic conditions, including asthma, arthritis, diabetes, asthma, bronchitis, emphysema, heart disease, hypertension and epilepsy.

``The most striking finding is how little HMOs and indemnity plans differ in the prevalence of chronic conditions,'' wrote Teresa Fama of the Group Health Foundation, Peter D. Fox of PDF Inc. and Leigh Ann White of Project Hope Center for Health Affairs.

Fama is deputy director of the Johnson foundation-sponsored Office for Chronic Care Initiatives in HMOs at the Group Health Foundation. The Group Health Foundation is an arm of the Group Health Association of America, an HMO lobbying organization.

Almost 77 percent of both groups - those in HMOs and those in fee-for-service plans - rated their health as excellent or good. Only 4.9 percent of those in fee-for-service plans and 4.6 percent of those in HMOs said it was fair or poor. The rest said it was good.

Those with fee-for-service coverage were more likely than those in HMOs not to have been hospitalized in the previous year (52 percent to 49 percent), but the fee-for-service group also had a slight edge among those who logged more than 30 days in hospitals (1.5 percent vs. 1.3 percent).

``If HMOs do benefit from favorable selection, we believe that the bias is minimal overall,'' said the authors, adding, ``HMOs have been no more successful than indemnity plans ... at risk selection.''

More than 50 million Americans are enrolled in HMOs, which have experienced rapid growth as employers and consumers search for ways to hold down their medical bills and insurance premiums.

Only 10 percent of the elderly are in HMOs. Republicans in Congress are working on plans to sharply curtail the growth of both Medicare and Medicaid, the government's big insurance program for the poor, and their prescriptions are expected to include a much heavier dose of managed care for both groups.