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April 1991, Vol. 114, No. 4

Health maintenance organizations: plan offerings and enrollments

Michael Bucci


T he rising cost of health care has created a dilemma for both employers and employees, encouraging them to search for ways to cut their health care costs. To do this, employers increasingly are sharing the costs of employers-sponsored health insurance with their employees, while employees are turning to health maintenance organization (HMO) plans, which generally require few out-of-pocket expenses beyond plan premiums. Employee participation in HMO plans increased during the 1980's, suggesting an effort on the part of workers and their families to keep their health care costs at a more manageable level.

The number of employees offered an HMO plan by their employer continued to increase in the 1980's, as did the number of employees who choose HMO's as a method of receiving health care. Many of these newly eligible employees were offered plans financed jointly by employers and employees; consequently, the proportion of workers offered wholly employer-financed HMO's declined noticeably.

The growth in HMO plan availability and enrollment is apparent throughout the country, although there are distinct regional and industry differences. For example, between 1984 and 1987, the percent of full-time office employees in finance, insurance, and real estate establishments who were offered an HMO increased by 15 percentage points, while the increase for the office workers in manufacturing was 7 percentage points. Likewise, plan offerings to full-time production workers in the South increased between 1984 and 1987, but remained stable in the West. Other industry and regional variations exist in the degree of employee participation in HMO's and in the percentage of workers offered plans fully paid by employers.


This excerpt is from an article published in the April 1991 issue of the Monthly Labor Review. The full text of the article is available in Adobe Acrobat's Portable Document Format (PDF). See How to view a PDF file for more information.

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