The effect of insurance status on travel time for rural medicare patients

Liam O'Neill

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Managed care has been hypothesized to increase patient travel by directing patients toward network providers. The purpose of this study is to measure the effect of Medicare HMO enrollment on hospital travel time in rural areas. Hospital travel times were determined for 85,586 inpatient discharges among rural Pennsylvania residents admitted to Pennsylvania hospitals in 1998. Medicare HMO enrollees traveled up to 10.2 minutes further for acute care than Medicare fee-for-service patients (39 versus 29 minutes). Medicare HMO enrollees were 50 percent more likely to travel outside their own counties and 70 percent more likely to travel to urban areas for acute care. The distance premium associated with HMO enrollment was largest in counties with the lowest managed care penetration.

Original languageEnglish
Pages (from-to)187-202
Number of pages16
JournalMedical Care Research and Review
Issue number2
StatePublished - 1 Jun 2004


  • Hospital distance
  • Medicare HMO
  • Rural access


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