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Related Experiment Videos

Selecting affiliates for a national HMO network: developing and implementing performance standards.

C H Coulter1

  • 1UltraLink, Costa Mesa, CA.

Managed Care Quarterly
|December 4, 1993
PubMed
Summary

A unique evaluation process led to the success of a health network and its Health Maintenance Organizations (HMOs). This approach improved member satisfaction and financial performance, enabling national expansion.

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Area of Science:

  • Health Services Research
  • Healthcare Management

Background:

  • Health Maintenance Organizations (HMOs) face challenges in meeting diverse member and employer needs.
  • Developing effective evaluation processes is crucial for network success and performance improvement.

Purpose of the Study:

  • To present an evaluation process designed for a specific healthcare network.
  • To assess the effectiveness of this process in enhancing HMO performance and network growth.

Main Methods:

  • The study describes a unique evaluation framework tailored to a specific healthcare network.
  • Performance metrics likely included member satisfaction, employer requirements, and financial indicators.

Main Results:

  • The implemented evaluation process was effective, leading to the success of the network and its affiliated HMOs.

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  • HMOs achieved success in meeting member and employer requirements.
  • National network affiliation resulted in increased membership and revenue for the HMOs.

    • Conclusions:

    • The developed evaluation process proved effective in optimizing HMO performance and network growth.
    • The network's success supports the validity of the unique evaluation approach.
    • Affiliated HMOs are positioned for a transition to a national healthcare delivery system.