HMO Decline Stabilizing in Oregon and Washington, Study Says

April 1, 2005 ( - The decline in HMO membership in Oregon and Washington is slowing, while PPO growth is not as dramatic as in the past, according to a new study.

HealthLeaders-InterStudy , a provider of managed care industry intelligence, has announced in its “Oregon & Washington Health Plan Analysis” that the decline in HMO membership has stabilized. From January 2003 to the same month in 2004 in Oregon, membership in such organizations fell from 42.6% of market share to 32.3%. However, by mid-2004, this number had only dropped to 28.9%, according to a press release from the company.

An almost identical trend was noticed in Washington, according to the study.

“HMOs have been evolving to include fewer restrictions, making them moreattractive to consumers. As a result, the mix of HMO and PPO membershipis stabilizing,” said Micaela Brown, HealthLeaders-InterStudy analyst, in the news release. “At the same time, employers are looking for gatekeeper features likeutilization and care management.”

The study also noted that plans in both states that have initiated pay-for-performance arrangements for physicians are reporting “good cooperation and little pushback from the doctors involved.”

Also of note is that Oregon’s Insurance Pool Governing Board has created two new health plans for small businesses that have, before now, been unable to provide health insurance for employees.

In Washington, the study notes, the notoriously partisan legislature has come together to sponsor “pay-or-play” bills that would require employers to aid in the funding of benefits for the uninsured.