Private Payers Serving Individuals with Disabilities and Chronic Conditions

Appendix C: Statistical Analyses


TABLE OF CONTENTS

Table C-1. Characteristics of Indemnity Plan Stayers and Switchers: Employer A
Table C-2. Characteristics of Indemnity Plan Stayers and Switchers: Employer A
Table C-3a. Characteristics of Indemnity Plan Stayers and Switchers: Employer B
Table C-3b. Characteristics of Indemnity Plan Stayers and Switchers: Employer B
Table C-4a. Characteristics of Indemnity Plan Stayers and Switchers: Employer B
Table C-4b. Characteristics of Indemnity Plan Stayers and Switchers: Employer B
Table C-5. Characteristics of Indemnity Plan Stayers and Switchers: Employer A
Table C-6. Characteristics of Indemnity Plan Stayers and Switchers: Employer B


TABLE C-1. Characteristics of Indemnity Plan Stayers and Switchers: Employer A
Measure Stayers in Indemnity
N=19424		 Switchers from
Indemnity to POS
N=2191
DEMOGRAPHIC CHARACTERISTICS
Mean age 52.91 49.56*
% female 30.68 28.80
EMPLOYMENT STATUS
% employed full time 64.19 79.55*
% early retirees 36.57 20.77*
PER SE DISABILITY CATEGORY--1995
% adults with any physical disability 62.01 52.85*
% adults with any mental disability 4.87 4.56
% adults with physical and mental disabilities 1.84 1.41
PER SE DISABILITY CATEGORY--1994
% adults with any physical disability 54.39 48.97*
% adults with any mental disability 4.68 3.74*
% adults with physical and mental disabilities 1.54 0.91*
ACTIVITY-LIMITING CONDITION
% with condition in 1995 50.07 44.87*
% with condition in 1994 57.20 56.18
HEALTH CONDITIONS
Mean number of MDCs in 1995 3.97 3.79*
Mean number of unique MDCs in 1994 3.72 3.34*
INPATIENT CARE
% hospitalized during 1995 16.87 13.42*
% hospitalized during 1994 15.76 13.01*
INPATIENT CARE AMONG INPATIENT USERS--1995 Stayers
N=3276		 Switchers
N=294
Mean number of hospital admissions 1.42 1.44
Mean length of stay per admission 5.79 4.93
Mean total length of stay 8.72 7.44
Median inpatient payment 10,382.00 8,209.50*
INPATIENT CARE AMONG INPATIENT USERS--1994 Stayers
N=3062		 Switchers
N=285
Mean number of hospital admissions 1.43 1.26*
Mean length of stay per admission 5.84 4.32*
Mean total length of stay 8.92 5.59*
Median inpatient payment 10,863.50 7,670.00*
OUTPATIENT CARE--1995
Mean number of outpatient claim-days 13.57 13.82
Median outpatient payments 1,312.00 1,152.00*
OUTPATIENT CARE--1994
Mean number of outpatient claim-days 13.07 10.36*
Median outpatient payments 1,179.00 894.00*
REHABILITATION SERVICE USE
% using rehabilitation services – 1995 8.20 12.92*
% using rehabilitation services – 1994 17.60 17.75
TOTAL PAYMENTS--1995
Mean total inpatient and outpatient payments 6,323.63 4,793.64*
Median total inpatient and outpatient payments 1,485.50 1,248.00*
TOTAL PAYMENTS--1994
Mean total inpatient and outpatient payments 5,965.76 3,938.54*
Median total inpatient and outpatient payments 1,317.50 1,012.00*
PRESCRIPTION DRUGS FOR USERS 1995** Stayers
N=16183		 Switchers
N=1099
Mean number of prescription drug claims 17.86 11.19*
Median number of prescription drug claims 13.00 8.00*
Mean total prescription drug payments 784.33 717.13
Median total prescription drug payments 455.16 441.82
Mean total payments Inpatient + Outpatient + Prescription drugs 7,494.71 5,390.94*
Median total payment Inpatient + Outpatient + Prescription drugs 2,463.94 2,179.46*
* Significance at the p=0.05 level. Chi-squared statistics and unequal-variance t-tests were used to test for differences in percentages and means, respectively.
** Due to data limitations, prescription drug measures are calculated only for users of these services.


TABLE C-2. Characteristics of Indemnity Plan Stayers and Switchers: Employer A
Measure Stayers in Indemnity
N=19424 		Switchers from Indemnity to POS
N=2191
1994 1995 1994 1995
CHARACTERISTICS
Any physical disability 54.39 62.01* 48.97 52.85*
Any mental disability 4.68 4.87 3.74 4.56
Both physical and mental disabilities 1.54 1.84* 0.91 1.41
% employed full time 57.20 50.07* 56.18 44.87*
Mean number of unique MDCs 3.72 3.97* 3.34 3.79*
INPATIENT CARE
% hospitalized 15.76 16.87* 13.01 13.42
OUTPATIENT CARE
Mean number of outpatient claim-days 13.07 13.57* 10.36 13.82*
Median total outpatient payments 1,179.00 1,312.00* 894.00 1,152.00*
REHABILITATION SERVICE USE
% using rehabilitation services 17.60 8.19* 17.75 12.92*
ACTIVITY-LIMITING CONDITION
Mean total inpatient + outpatient payments 5,965.76 6,323.63* 3,938.54 4,793.64*
INPATIENT CARE AMONG INPATIENT USERS 1994 Stayers
N=3062		 1995 Stayers
N=3276		 1994 Switchers
N=285		 1995 Switchers
N=294
Mean number of hospital admissions 1.43 1.42 1.26 1.44*
Mean length of stay per admission 5.84 5.79 4.32 4.93
Mean total length of stay 8.92 8.72 5.59 7.44*
Median total inpatient payments 10,863.50 10,382.00 7,670.00 8,209.50
* Significance at the p = 0.05 level. Chi-squared statistics and unequal-variance t-tests were used to test for differences in percentages and means, respectively.


TABLE C-3a. Characteristics of Indemnity Plan Stayers and Switchers: Employer B
Measure Stayers in Indemnity
N=22784		 Switchers from
Indemnity to HMO
N=332
DEMOGRAPHIC CHARACTERISTICS
Mean age 44.15 37.08*
Gender (% female) 55.00 53.92
EMPLOYMENT STATUS
% employed full time 82.04 94.28*
% early retirees 16.28 5.428
% other employment status 1.69 0.30
INSURANCE STATUS
% Employee 57.11 55.12*
% Spouse 26.63 19.28
% Dependent 16.27 25.60
PER SE DISABILITY CATEGORY--1995
% adults with any physical disability 47.36 37.95*
% adults with any mental disability 6.75 7.23
% adults with physical and mental disabilities 2.82 2.41
PER SE DISABILITY CATEGORY--1994
% adults with any physical disability 45.66 33.13*
% adults with any mental disability 6.57 5.42
% adults with physical and mental disabilities 2.35 1.51
ACTIVITY-LIMITING CONDITION
% with condition in 1995 40.87 30.12*
% with condition in 1994 45.92 34.94*
HEALTH CONDITIONS
Inpatient Care among Inpatient Users – 1995 4.38 4.67*
Mean number of unique MDCs in 1994 4.29 3.89*
INPATIENT CARE
% hospitalized during 1995 11.44 8.73
% hospitalized during 1994 11.69 12.05
OUTPATIENT CARE--1995
Mean number of outpatient claim-days 14.71 12.63*
Median outpatient payments 1,500.00 1,053.00*
OUTPATIENT CARE--1994
Mean number of outpatient claim-days 14.56 11.99*
Median outpatient payments 1,540.00 1,138.50*
REHABILITATION SERVICE USE
% using rehabilitation services – 1995 22.52 20.48
% using rehabilitation services – 1994 21.97 21.39
TOTAL PAYMENTS--1995
Mean total inpatient and outpatient payments 5,267.08 2,530.67*
Median total inpatient and outpatient payments 1,587.50 1,067.50*
TOTAL PAYMENTS--1994
Mean total inpatient and outpatient payments 5,146.18 3,537.13*
Median total inpatient and outpatient payments 1,630.00 1,206.50*
SOURCE: 1995 MarketScan® data, The Medstat Group, Inc.
* Significance at p = 0.05 level. Chi-squared statistics and unequal-variance t-tests were used to test for differences in percentages and means, respectively.


TABLE C-3b. Characteristics of Indemnity Plan Stayers and Switchers: Employer B
Measure Stayers in Indemnity
N=21618		 Switchers from
Indemnity to HMO
N=310
DEMOGRAPHIC CHARACTERISTICS
Mean age 36.28 37.68
Gender (% female) 54.55 57.10
EMPLOYMENT STATUS
% employed full time 94.30 89.35
%early retirees 5.14 9.35
% other employment status 0.56 1.29
INSURANCE STATUS
% Employee 51.55 58.06*
%Spouse 24.04 18.06
% Dependent 24.41 23.87
PER SE DISABILITY CATEGORY--1995
% adults with any physical disability 34.32 40.97*
% adults with any mental disability 5.07 8.06*
% adults with physical and mental disabilities 1.67 0.65
PER SE DISABILITY CATEGORY--1994
% adults with any physical disability 30.14 26.77
% adults with any mental disability 4.42 3.87
% adults with physical and mental disabilities 1.39 1.94
ACTIVITY-LIMITING CONDITION
% with condition in 1995 28.17 37.74*
% with condition in 1994 30.60 31.94
HEALTH CONDITIONS
Inpatient Care among Inpatient Users – 1995 4.38 4.67*
Mean number of unique MDCs in 1994 3.58 3.89
OUTPATIENT CARE--1995
Mean Number of outpatient claim-days 11.72 14.93*
Median outpatient payments 799.00 1,387.50*
OUTPATIENT CARE--1994
Mean Number of outpatient claim-days 11.17 10.42
Median outpatient payments 608.00 569.50
REHABILITATION SERVICE USE
% using rehabilitation services – 1995 22.52 30.97*
% using rehabilitation services – 1994 27.55 23.23
TOTAL PAYMENTS--1995
Mean total inpatient and outpatient payments 2,860.55 4,347.44*
Median total inpatient and outpatient payments 845.00 1,387.50*
TOTAL PAYMENTS--1994
Mean total inpatient and outpatient payments 2,391.47 2,254.82
Median total inpatient and outpatient payments 647.00 591.00
* Significance at p = 0.05 level. Chi-squared statistics and unequal-variance t-tests were used to test for differences in percentages and means, respectively.


TABLE C-4a. Characteristics of Indemnity Plan Stayers and Switchers: Employer B
Measure Stayers in Indemnity
N=22784 		Switchers from Indemnity to POS
N=332
1994 1995 1994 1995
CHARACTERISTICS
Any physical disability 45.66 47.36* 33.13 37.95*
Any mental disability 6.57 6.75 5.42 7.23
Both physical and mental disabilities 2.35 2.82* 1.51 2.41
% employed full time 45.92 40.87 34.94 30.12
Mean number of unique MDCs 4.29 4.38* 3.89 4.67*
OUTPATIENT CARE
Mean number of outpatient claim-days 14.56 14.71 11.99 12.63
Median total outpatient payments 1,540.00 1,500.00* 1,138.50 1,053.00
REHABILITATION SERVICE USE
% using rehabilitation services 21.97 22.52 21.39 20.48
TOTAL PAYMENTS
Mean total inpatient + outpatient payments 1,630.00 1,587.50* 1,206.50 1,067.50*
Median total inpatient + outpatient payments 5,164.18 5,267.08 3,537.13 2,530.67*
SOURCE: 1995 MarketScan® data, The MEDSTAT Group, Inc.
* Significance at the p = 0.05 level. Chi-squared statistics and unequal-variance t-tests were used to test for differences in percentages and means, respectively.


TABLE C-4b. Characteristics of Indemnity Plan Stayers and Switchers: Employer B
Measure Stayers in HMO
N=21618 		Switchers from HMO to Indemnity
N=310
1994 1995 1994 1995
CHARACTERISTICS
Any physical disability 30.14 34.32* 26.77 40.97*
Any mental disability 4.42 5.07* 3.87 80.6*
Both physical and mental disabilities 1.39 1.67* 1.94 0.65
% employed full time 30.60 28.17 31.94 37.74
Mean number of unique MDCs 3.59 3.99* 3.58 4.38*
OUTPATIENT CARE
Mean number of outpatient claim-days 11.17 11.72* 10.42 14.93*
Median total outpatient payments 608.00 799.00* 569.50 1,387.50*
REHABILITATION SERVICE USE
% using rehabilitation services 27.55 22.52* 23.23 30.97
TOTAL PAYMENTS
Mean total inpatient + outpatient payments 2,391.47 2,860.55 2,254.82 4,347.77
Median total inpatient + outpatient payments 647.00 845.00 591.00 1,387.50*
SOURCE: 1995 MarketScan® data, The MEDSTAT Group, Inc.
* denotes p <= 0.05. Chi-squared statistics and unequal variance t-tests were used to test for differences in percentages and means, respectively.


TABLE C-5. Characteristics of Indemnity Plan Stayers and Switchers: Employer A
Measure Total
(N=23270)
Percentage 		POS 1995
(N=11061)
Percentage 		Indemnity 1995
(N=12209)
Percentage
CHARACTERISTICS
Metropolitan statistical area 86.1 91.93 80.83*
EMPLOYMENT STATUS
Active full-time 66.09 75.4 57.65*
Early retiree 31.22 22.81 38.85
Other 2.69 1.79 3.5
PER SE DISABILITY CATEGORY--1995
Physical disability only 91.8 91.42 92.15*
Mental disability only 5.69 6.44 5.02
Physical and mental disability 2.51 2.14 2.83
Activity limiting condition 67.32 64.87 69.54*
Health Care Usage 1995 Activity- Limiting Condition 8.04 9.65 6.59*
Measure Total
(N=23270) 		POS 1995
(N=11061) 		Indemnity 1995
(N=12209)
Mean Standard
Deviation		 Mean Standard
Deviation		 Mean Standard
Deviation
CHARACTERISTICS
Age 52.053 (9.832) 50.242 (9.943) 53.694 (9.436)
Number of unique MDC categories 4.252 (2.190) 4.188 (2.092) 4.31 (2.273)**
HEALTH CARE USE--1995
Number of outpatient claim-days 15.75 (14.270) 16.37 (13.150) 15.18 (15.180)**
Number of hospital admissions 0.282 (0.699) 0.261 (0.661) 0.301 (0.731)**
Length of stay 1.652 (7.063) 1.466 (6.762) 1.821 (7.322)**
EXPENDITURES--1995
Total inpatient payments 3579.78 (14790.910) 2940.85 (14168.050) 4158.63 (15310.950)**
Total outpatient payments 3315.01 (6132.790) 2861.28 (5298.540) 3726.08 (6774.850)**
Total payments 6894.79 (17478.820) 5802.13 (16099.080) 7884.71 (18586.140)**
ACTIVITY-LIMITING CONDITION
Number of prescriptions 18.15 (18.420) 15.1 (15.500) 20.1 (19.810)**
Total drug expenditures 851.47 (1184.870) 757.88 (978.870) 911.25 (1295.980)**
Total payments including drug expenditures 8254.03 (18189.790) 6870.14 (16289.740) 9137.94 (19254.530)**
SOURCE: 1995 MarketScan® data, The MEDSTAT Group, Inc.
NOTES: *, ** denote p <= 0.05 and 0.01, respectively. Chi-squared statistics and unequal variance t-tests were used to test for differences between the POS and Indemnity subgroups.
1. Due to data limitations, prescription drug measures are calculated only for users of these services.


TABLE C-6. Characteristics of Indemnity Plan Stayers and Switchers: Employer B
Measure Total
(N=22801) 		HMO 1995
(N=9686) 		Indemnity 1995
(N=13115)
Number Percentage Number Percentage Number Percentage
CHARACTERISTICS
Metropolitan statistical area 22517 98.75 96.39 99.51 12878 98.19**
INSURANCE STATUS
Employee 12658 55.52 4907 50.66 7751 59.1**
Spouse 5729 25.13 2340 24.16 3389 25.84
Dependent 4414 19.36 2439 25.18 1975 15.06
EMPLOYMENT STATUS
Active full-time 19404 85.1 8981 92.72 10423 79.47**
Early retiree 3086 13.53 648 6.69 2438 18.59
Other 311 1.36 57 0.59 254 1.94
PER SE DISABILITY CATEGORY--1995
Physical disability only 19229 84.33 8046 83.07 11183 85.27**
Mental disability only 2439 10.7 1192 12.31 1247 9.51
Physical and mental disability 1133 4.97 448 4.63 685 5.22
Activity limiting condition 13824 60.63 5645 58.28 8179 62.36**
Activity limiting condition both years 7046 30.9 2629 27.14 4417 33.67**
Per se disability condition both years 12945 56.77 50.35 51.98 7910 60.31**
HEALTH CARE USE--1995
Any rehabilitation services 3588 15.74 1527 15.77 2061 15.71
Measure Total
(N=22801) 		HMO 1995
(N=9686) 		Indemnity 1995
(N=13115)
Mean Standard
Deviation		 Mean Standard
Deviation		 Mean Standard
Deviation
CHARACTERISTICS
Age 41.837 (18.003) 37.145 (18.243) 45.300 (17.013)**
Number of unique MDC categories 4.721 (2.230) 4.721 (2.228) 4.808 (2.380)**
HEALTH CONDITIONS 1994
Number of unique MDC categories 4.123 (2.232) 4.123 (2.232) 4.351 (2.369)**
HEALTH CARE USE--1995
Number of outpatient claim-days 15.290 (14.310) 13.990 (13.310) 16.240) (14.930)**
Number of hospital admissions 0.218 (0.752) 0.200 (0.697) 0.231 (0.790)**
Length of stay 1.311 (7.204) 1.125 (6.880) 1.451 (7.438)**
HEALTH CARE USE--1994
Number of outpatient claim-days 13.57 (13.540) 12.02 (12.010) 14.72 (14.460)**
Number of hospital admissions 0.175 (0.652) 0.147 (0.565) 0.196 (0.708)**
Length of stay 1.137 (8.562) 0.889 (7.028) 1.32 (9.534)**
EXPENDITURES--1995
Total inpatient payments 2464.87 (12307.510) 1816.21 (10284.190) 2943.94 (13590.580)**
Total outpatient payments 3228.8 (6987.740) 2308.9 (5127.030) 3908.19 (8024.550)**
Total payments 5693.68 (15800.610) 4125.11 (12960.580) 6852.13 (17516.950)**
EXPENDITURES--1994 (1995 dollars)
Total inpatient payments 2030.29 (10968.270) 1375.38 (9034.590) 2513.97 (12178.960)**
Total outpatient payments 2761.06 (6213.520) 1807.98 (4054.040) 3464.96 (7336.160)**
Total payments 4791.36 (14326.030) 3183.36 (10917.670) 5978.93 (16293.340)**
SOURCE: 1995 MarketScan® data, The MEDSTAT Group, Inc.
NOTES: Unequal variance t-tests were used to determine statistically significant differences between the HMO and Indemnity subgroups.


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