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Related Experiment Videos

HMOs may be ready to drop costly physicians.

D E Johnson

    Health Care Strategic Management
    |May 27, 1999
    PubMed
    Summary

    Health Maintenance Organizations (HMOs) are reducing physician networks to control costs. This reversal may lead to 20-30% of physicians losing their HMO contracts in certain regions.

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    Area of Science:

    • Health Economics
    • Managed Care Policy

    Background:

    • Health Maintenance Organizations (HMOs) previously expanded physician networks to boost enrollment.
    • Rising healthcare expenditures necessitate cost-control measures within managed care organizations.

    Purpose of the Study:

    • To investigate the trend of HMOs potentially reversing physician network expansion.
    • To identify the driving factors behind this strategic shift in managed care.

    Main Methods:

    • Analysis of current managed care contracting practices.
    • Review of regional data on physician network adjustments.

    Main Results:

    • HMOs are actively reducing the size of their physician panels.
    • This strategic shift is primarily driven by a need to control organizational expenditures.
    • In some regions, contract terminations could affect 20% to 30% of physicians.

    Conclusions:

    • HMOs are prioritizing cost containment over network breadth.
    • Physician participation in HMO networks may become more selective.
    • This trend signals a significant change in managed care provider relationships.

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