Why primary care physicians join HMOs

To determine the reasons why primary care physicians affiliate with health maintenance organizations (HMOs) and assess how these reasons vary with personal and practice characteristics.

A 1996 national telephone/mail survey of primary care physicians who were affiliated with at least 1 HMO plan for more than 9 months.

Survey responses were assessed according to geographic region, age, income, level of involvement in managed care, and HMO penetration rate. The sample consisted of 210 primary care physicians who played a role in the decision to affiliate.

The overwhelming reason primary care physicians affiliated with an HMO was to retain patients. Eighty-three percent reported this as one of the reasons for affiliating and 59% reported it as the primary reason. Physicians with the greatest portion of income from managed care and physicians practicing in areas with high HMO penetration were most likely to report quality of life issues--such as more personal time, more predictable work hours, or reduced administrative burden--as the rationale for HMO plan affiliation.

These findings support the view that the majority of HMO-affiliated physicians join HMOs to avoid a perceived penalty associated with lack of affiliation, rather than for positive reasons. The data also suggest that physicians with managed care experience affiliate more often for quality of life reasons.