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Related Experiment Videos

Breaking through the rhetoric on HMO quality.

D L Scofield

    Health Cost Management
    |June 8, 1988
    PubMed
    Summary

    Employers must evaluate health maintenance organizations (HMOs) on factors beyond quality of care. Key areas include finances, delivery systems, data, and service results to ensure informed contract decisions.

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    Area of Science:

    • Healthcare Management
    • Health Services Research
    • Managed Care Organizations

    Background:

    • Health maintenance organizations (HMOs) often fail to compete on documented quality of care.
    • Employers require alternative methods to assess HMO quality.

    Purpose of the Study:

    • To provide employers with a framework for evaluating HMOs.
    • To identify critical questions for assessing HMOs before contract signing.

    Main Methods:

    • Review of current managed care market dynamics.
    • Identification of key assessment areas for employer evaluation of HMOs.

    Main Results:

    • HMOs are not consistently evaluated on quality metrics.
    • Employers should focus on financial stability, delivery system structure, data collection capabilities, and service outcomes.

    Conclusions:

    • Employers must adopt a multi-faceted approach to vetting HMOs.
    • Financial and operational assessments are crucial in the absence of robust quality data.

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