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Medicare-risk health maintenance organizations appear to target healthy seniors in their advertising and marketing rather than beneficiaries in poor health or non-elderly, disabled persons eligible for Medicare, according to a study.

But that advertising is not thwarting employer efforts to shift retirees to Medicare-risk HMOs, a benefit consultant and a corporate benefit manager maintain.

"Employers don't rely on this marketing process (to recruit retirees)," said Joseph Martingale, a principal at New York-based benefit consultant Towers Perrin. "Employers do their own marketing, which is much more thorough."

The study, released last week and conducted by the Henry J. Kaiser Family Foundation, a Menlo Park, Calif.-based philanthropic organization that sponsors health care research, and the Washington office of Porter Novelli, a public relations firm, examined Medicare risk HMO marketing in Cleveland, Los Angeles, Miami and New York between Jan. 1 and March 31, 1997. Researchers reviewed 70 newspaper ads and 27 television ads and attended 21 Medicare-risk HMO marketing seminars.

The study found that most ads pitch lower costs and better benefits, and that marketing seminars are not consistently accessible to beneficiaries with physical disabilities. The study also found that much important information in ads is in fine print that is difficult for older people to read.

The study concluded HMO "marketing materials could be improved to help beneficiaries with these critical health insurance choices."

But Medicare-risk HMO advertising and marketing approaches did not discourage 25% of Bethlehem Steel Corp.'s 70,000 eligible retirees from joining Medicare-risk HMOs, said Jack Romeo, director of health care systems for Bethlehem Steel in Bethlehem, Pa. He acknowledges, though, that the ads may affect an employer's ability to encourage beneficiaries in poor health to join such plans.

"If Kaiser says to retirees, 'HMOs don't advertise to sick people,' then people will think HMOs don't want sick people," said Mr. Romeo. "But I don't think HMOs are hindering our recruitment efforts. They don't advertise to sick people, but I don't know how you could do that anyway."

He said employers should worry about being held liable if an HMO doesn't deliver all the services its ad indicates it will. "We should be concerned that (retirees) might complain," he said. "Certainly employers can be sued. But I hope a court of law wouldn't hold employers responsible for what an HMO printed."

Santa Ana, Calif.-based PacifiCare Health Systems Inc., the nation's largest Medicare-risk HMO with nearly 1 million enrollees in 10 states, disputes the study's results.

"The findings say that we are erroneously depicting the state of health care," said a PacifiCare spokesman, adding that the survey's conclusions detract from beneficiaries' ability to weigh the facts for themselves.

"When you consider that most people aspire to good health," is it logical to assume advertisements will depict a sick or physically challenged senior? "When I look at allergy ads, do I honestly think I can run through a field of flowers like the guy in the ad? Our goal is to help people improve their health, or at least maintain it," the PacifiCare spokesman said.

Free single copies of "Marketing HMOs to Medicare Beneficiaries" are available from the Henry J. Kaiser Family Foundation publication request line, at 1-800-656-4533. Specify publication number 1417.