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Related Experiment Videos

Evolutionary development of systems.

P Aaronson

    Computers in Healthcare
    |January 10, 1988
    PubMed
    Summary

    The number of Health Maintenance Organizations (HMOs) and enrollment is growing, raising questions about system capabilities. Current systems may struggle with complex benefit plans and provider networks.

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    Area of Science:

    • Healthcare Management
    • Health Economics

    Background:

    • Managed care has seen significant growth, leading to an increase in Health Maintenance Organizations (HMOs) and enrollment.
    • This expansion necessitates robust systems capable of managing intricate healthcare operations.

    Purpose of the Study:

    • To assess the capacity of existing systems to meet the growing demands of Health Maintenance Organizations (HMOs).
    • To identify potential challenges in managing complex benefit plans and provider networks within expanding managed care environments.

    Main Methods:

    • Analysis of current system capabilities in relation to HMO operational requirements.
    • Review of complexities associated with multiple benefit structures and provider agreements.

    Main Results:

    • The dynamic growth of HMOs and their enrollment presents challenges for existing systems.
    • Current capabilities may be insufficient to handle the complexities of diverse benefit plans and provider relationships.

    Conclusions:

    • Further development and adaptation of systems are required to support the expanding needs of Health Maintenance Organizations (HMOs).
    • Addressing system limitations is crucial for the effective management of complex healthcare networks.

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