Enrollment varies across the United States. For example, over 20 percent of Medicare beneficiaries in San Francisco are enrolled in HMOs while only one percent are enrolled in Detroit. Payments can vary from region to region as well. The author of this editorial discusses several factors which can contribute to successful relationships for both physicians and Medicare beneficiaries in HMOs. Rowe, John W. Geriatrics, Prevention, and the Remodeling of Medicare.
Geriatric medicine has to date focused on dealing with chronic and acute conditions in the elderly.
Preventive medicine has focused on those individuals who are young and middle-aged. The author of this editorial suggests that prevention can be successful in the elderly as well and that the Medicare program should lead a preventive effort for this population. Even if adopted late in life, lifestyle changes can increase active life expectancies, decrease disability, and reduce health expenditures by the government and individuals.