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Health care delivery systems in review.
The Journal of Medical Practice Management : MPM
|January 4, 1989
Summary
Health maintenance organizations (HMOs) face significant financial challenges, potentially impacting care access. Rising manager salaries may worsen financial strain, though government contracts offer new member opportunities.
Area of Science:
- Healthcare Management
- Health Economics
Background:
- Health maintenance organizations (HMOs) experienced severe financial difficulties in 1986.
- Similar financial trends are projected for 1987.
Purpose of the Study:
- To analyze the financial health of HMOs.
- To identify factors contributing to financial burdens.
- To explore potential solutions for financial stability.
Main Methods:
- Analysis of financial data from 1986 and projections for 1987.
- Review of legislative considerations regarding HMO solvency requirements.
- Examination of salary trends for HMO managers.
- Assessment of opportunities presented by government contracts.
Main Results:
- HMOs faced substantial financial problems in 1986, with expectations of similar issues in 1987.
- Increased manager salaries are identified as a contributing factor to financial strain.
- Several states are considering new solvency requirements for HMOs.
- Medicare and CHAMPUS contracts represent potential avenues for membership growth.
Conclusions:
- HMO financial instability poses risks to providers and enrollees.
- Regulatory and operational adjustments are necessary for HMOs.
- Government contracts may offer a pathway to increased membership and improved financial standing.