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This article addresses several questions about the effect of disenrollment on the start-up phenomenon in health maintenance organizations that were raised in a recent exchange of articles and comments in this journal. The results show that disenrollees, like continuous enrollees, go through a start-up phase of utilization that decreases over duration of membership to a stable lower level. The study also differentiates between voluntary and involuntary disenrollees, both of which go through start-ups. The different characteristics of the start-ups of both groups of disenrollees are contrasted with those of continuous enrollees. The implications of these findings for planners and administrators are discussed, and a future research agenda is recommended.
M J Griffith, and
N Baloff, and
E L Spitznagel
November 1985,
Medical care,
M J Griffith, and
N Baloff, and
E L Spitznagel
January 1987,
GHAA journal,
M J Griffith, and
N Baloff, and
E L Spitznagel
September 1974,
New York state journal of medicine,
M J Griffith, and
N Baloff, and
E L Spitznagel
November 1998,
Medical care,
M J Griffith, and
N Baloff, and
E L Spitznagel
February 1982,
The Journal of family practice,
M J Griffith, and
N Baloff, and
E L Spitznagel
February 1996,
The Journal of nursing administration,
M J Griffith, and
N Baloff, and
E L Spitznagel
November 1998,
The American journal of managed care,
M J Griffith, and
N Baloff, and
E L Spitznagel
January 1995,
Health care financing review,
M J Griffith, and
N Baloff, and
E L Spitznagel
January 1991,
DICP : the annals of pharmacotherapy,
M J Griffith, and
N Baloff, and
E L Spitznagel
October 1971,
The Journal of the Florida Medical Association,
