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Related Experiment Videos

Social HMOs: lessons learned and future direction.

T C Schwab1

  • 1SCAN Health Plan, Long Beach, CA 90806, USA.

Medical Interface
|November 3, 1996
PubMed
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The social Health Maintenance Organization (HMO) model, developed in the 1980s, offers comprehensive benefits and a modified funding approach. Its proven success has led to program expansion by the Health Care Financing Administration.

Area of Science:

  • Health Services Research
  • Public Health Policy
  • Gerontology

Background:

  • The "social HMO" concept emerged from a collaboration between Brandeis University and the Health Care Financing Administration (HCFA) in the early 1980s.
  • Initial pilot programs were launched in 1985 across four diverse US locations: Portland, Oregon; Minneapolis; Brooklyn, New York; and Long Beach, California.

Purpose of the Study:

  • To evaluate the success and impact of the social HMO model.
  • To inform the expansion strategy for the social HMO program.

Main Methods:

  • Implementation of social HMO programs at four initial sites.
  • Comparison of social HMOs to Medicare risk-contracting HMOs, noting differences in benefits and funding.

Main Results:

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  • The social HMO model demonstrated success, prompting further development and expansion.
  • The program offers more comprehensive benefits than traditional Medicare risk-contracting HMOs.

Conclusions:

  • The social HMO model is a viable and successful approach to integrated healthcare delivery for Medicare beneficiaries.
  • HCFA's decision to expand the program to six new sites underscores its positive outcomes and potential for broader application.