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Specialty services capitation contracting by HMOs.

¹Group Health Cooperative.

Medical Group Management Journal

|August 6, 1994

Summary

Health maintenance organizations (HMOs) are expanding contracting due to prepaid services. Research explored HMOs objectives, satisfaction, and evaluation methods in the US.

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Area of Science:

Health Services Research
Healthcare Management

Background:

The healthcare landscape is shifting towards prepaid service models.
This trend is driving increased contracting activities among Health Maintenance Organizations (HMOs).

Purpose of the Study:

To investigate the primary objectives and motivations behind HMO contracting.
To assess the satisfaction levels and evaluation methodologies employed by HMOs in their contracting processes.

Main Methods:

A research study was conducted examining 19 HMOs across the United States.
Data collection focused on understanding the strategic and operational aspects of HMO contracting.

Main Results:

Analysis of objectives, reasons for contracting, and satisfaction levels among participating HMOs.
Evaluation of the methods used by HMOs to assess their contracting activities.

Conclusions:

Findings provide insights into the current practices and effectiveness of HMO contracting strategies.
Understanding these factors is crucial for optimizing healthcare delivery within prepaid models.

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