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This variable is contained in the following files:
SAS Name
HMO_IND_01
Monthly Medicare Advantage (MA) enrollment indicator (January).
| Code | Code value |
|---|---|
| 0 | Not a member of an HMO |
| 1 | Non-lock-in, CMS to process provider claims |
| 2 | Non-lock-in, group health organization (GHO; MA plan) to process in plan Part A and in area Part B claims |
| 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 |
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).
Source: CMS Common Medicare Environment (CME)