Differences in Patient Treatment Across Types of Health Plans

Differences between managed care and indemnity health care plans have been a topic of recent debate. Claims resulting from the treatment of members diagnosed with asthma and/or arthritis were analyzed to compare the treatment of the same condition by the same provider across the two types of health plans. Analysis was performed for facility and for non-facility providers as trends were different in each case. Specifically, tests were performed to determine significant differences between types of plan in the mean cost per patient. Also, the types of procedures performed on patients in each type of plan were analyzed, and differences in the distributions of procedures (across and within types of procedures) were tested for significance. The age and gender distributions of the members, for whom claims were filed, were explored across and within the two types of plans.