Description

For persons in families with at least four comprehensive private insurance plans, HI4HMOR indicates whether the fourth plan mentioned was a health maintenance organization (HMO). This variable is similar to HI4HMOCOVR (Health Insurance Plan 4: HMO coverage recode), but HI4HMOR has not been recoded. HI4HMOR reports the verbatim response to the yes/no question, "Is this (name) plan a Health Maintenance Organization or HMO?"

Definitions

If respondents were unsure what an HMO was, interviewers provided a definition for them. The definition described HMOs and Individual Practice Associations (IPAs) as plans that provide members a network of providers, and generally require members to use only those health care providers within the network. Generally, members do not have to submit claims for costs of medical care services. An HMO directly provides its members with most or all of their health care, while traditional health insurers simply process claims.

Related variables

Please use the IPUMS NHIS drop-down menus and search function for other related variables.

Data Collection Process

Details about the characteristics of insurance plans (such as HI4HMOR) reflect plans for any family member in the household. In order to determine if the person (rather than someone else in the family) was covered by this plan, analysts should use the variable HI4PCOV (Health Insurance Plan 4: Person's Coverage Status), which indicates whether the person was covered by the plan.

Users are strongly encouraged to review the user notes Insurance Data Collection and Private Insurance Definitions.

Information was collected on up to four private plans.

Comparability

Apart from changes in the survey quarters in which this question was asked, there are no comparability issues. Using the prescribed IHIS weights eliminates comparability issues related to survey design.

HI4HMOR is not fully comparable with reported HMO coverage for 1997 forward or with the recoded variable HI4HMOCOVR since the latter reflect edits based on the plan name.

Because of the editing process that NCHS used to verify insurance status for 1997 forward, users should be cautious in analyzing type insurance plan (e.g., HMO, FFS, PPO, etc.) status over time. The pre-1997 variables, such as HI4HMOR and HI4HMOCOVR reflect reporting of private coverage that has not been verified for accuracy (i.e., not been subject to NCHS editing).

Universe

Availability

• 1993-1995

Weights

• 1994-1995 : PERWEIGHT
• 1993 : SAMPWEIGHT