HMO Indicator - April

SAS Name
HMO_IND_04

Monthly Medicare Advantage (MA) enrollment indicator (April).

Comments

Historically, most Medicare managed care plans have been health maintenance organizations (HMOs), hence the name of the variable.

This variable indicates whether the beneficiary was enrolled in a Medicare Advantage (MA) plan during a given month.

The 01 through 12 at the end of the variable name correspond with the month (i.e., 01 is January and 12 is December).

Code Code value
0 Not a member of an HMO
1 Non-lock-in, CMS to process provider claims
2 Fee-for-service participant in case or disease management demonstration project
4 Fee-for-service participant in case or disease management demonstration project
A Lock-in, CMS to process provider claims
B Lock-in, GHO to process in plan Part A and in area Part B claims
C Lock-in, GHO to process all provider claims