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Health care delivery systems in review.
The Journal of Medical Practice Management : MPM
|February 3, 1989
Summary
Health maintenance organizations (HMOs) faced financial difficulties in 1987 due to increased service use and costs. Despite challenges, HMO enrollment continued to grow, though at a slower pace.
Area of Science:
- Healthcare Management
- Health Economics
Background:
- Health maintenance organizations (HMOs) experienced significant financial distress in 1987.
- Key factors contributing to distress included increased outpatient service utilization, rising technology costs, and facility management expenses.
Purpose of the Study:
- To analyze the financial challenges faced by HMOs in 1987.
- To examine legislative responses to HMO insolvency.
- To assess trends in HMO enrollment despite financial difficulties.
Main Methods:
- Analysis of financial data for HMOs in 1987.
- Review of state-level legislative proposals concerning HMO solvency.
- Examination of HMO enrollment statistics.
Main Results:
- HMOs reported continued financial distress in 1987.
- Proposed legislation included guaranty funds to protect patients and providers from bankruptcies.
- HMO enrollment and the number of organizations continued to increase, albeit at reduced rates.
Conclusions:
- Financial instability remains a significant concern for HMOs.
- Legislative measures are being considered to mitigate the impact of HMO insolvency.
- The growth of HMOs persists despite ongoing financial challenges.