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Single workers with managed care health coverage take home an average of $191 to $252 per year more than they would if they weren't in managed care, though the savings vary widely from state to state, a new survey says.

The survey, commissioned by the American Assn. of Health Plans, estimates that savings were highest where the greatest number of people were enrolled in managed care plans. In areas where individual employees or families could take advantage of reduced premiums and out-of-pocket health care costs and presumed increased wages, gains were substantial. A married couple saved $408 to $549 on average through managed care, the survey said.

The Washington-based AAHP is the nation's leading trade organization for managed care networks.

The study, by Fairfax, Va.-based The Lewin Group, estimated that enrollment in health maintenance organizations will continue to grow for the rest of the decade and that 85% of workers will be in managed care by the year 2000-up from 75% now. Enrollment is expected to remain steady in preferred provider organizations and point-of-service plans.

The study estimates managed care savings for families for 1997 through 2000 will be $125 billion to $202 billion, similar to the savings achieved between 1990 and 1996.

The impact of managed care on families differs markedly by state. In California, where more than a third of the population is in managed care, the average savings per family ranged from $577 to $770 in 1996, or 14.7% as a percent of premiums. Oregon families saved $512 to $684, and Massachusetts families saved $775 to $1,035.

The lowest-ranking states in terms of family savings included Idaho, North Dakota, Alaska and South Dakota, where access to managed care is virtually non-existent and estimated value to a family is often less than $25 annually.

The study also contains these findings:

The hypothetical wage gain for a worker enrolled in managed care was $226 to $356, representing a wage increase of between 0.7% and 1%. The thinking behind these statistics is that in the absence of managed care, wages would have to be reduced by the cost-conscious employer.

Because of lower out-of-pocket premium costs and premium payments and higher wages under managed care, families with children last year saved $375 to $500.

The study was based on actual spending data for 1990 through 1996 and anticipated future spending for 1997 through 2000. The analysis was built on surveys of private employer health plans done by KPMG Peat Marwick, Hay-Huggins and A. Foster Higgins & Co. Inc., which has since merged with William M. Mercer Inc.

To receive a free copy of the report, "Managed Care Savings for Employers and Households: 1990 through 2000," fax a request to Paul Cummins, AAHP, 202-331-7487. The study also is available over the AAHP's Web site,