Codes and Frequencies
For persons in families with at least one comprehensive private insurance plan, HI1HMOR indicates whether the first plan mentioned was a health maintenance organization (HMO). This variable is similar to HI1HMOCOVR (Health Insurance Plan 1: HMO coverage recode), but H1HMOR has not been recoded. HI1HMOR reports the verbatim response to the yes/no question, "Is this (name) plan a Health Maintenance Organization or HMO?"
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.
Please use the IPUMS NHIS drop down menu and search functions for other related variables.
Data Collection Process
Details about the characteristics of insurance plans (such as HI1HMOR) 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 HI1PCOV (Health Insurance Plan 1: Person's Coverage Status), which indicates whether the person was covered by the plan.
Information was collected on up to four private plans. Thus, information about participation in an HMO through the family's private insurance plan(s) may appear in multiple variables: HI1HMO, HI2HMO, HI3HMO, and HI4HMO. Likewise, the complementary variables HI1PCOV, HI2PCOV, HI3PCOV, and HI4PCOV indicate coverage status for the individual under each plan.
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.
HI1HMOR is not fully comparable with reported HMO coverage for 1997 forward or with the recoded variable HI1HMOCOVR 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 HI1HMOR and HI1HMOCOVR reflect reporting of private coverage that has not been verified for accuracy (i.e., not been subject to NCHS editing). Users are encouraged to refer to HIPRIVATEE for more information on the editing process.
- 1993: Persons in quarters 3 and 4 covered by insurance other than a single service plan.
- 1994-1995: Persons covered by insurance other than a single service plan.