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Comparing the agreement among alternative models in evaluating HMO efficiency
C L Bryce1, J B Engberg, D R Wholey
1Center for Research on Health Care, University of Pittsburgh, PA 15213, USA.
Health Services Research
|June 17, 2000
Summary
Different efficiency models yield similar industry trends but vary in assessing individual health maintenance organization (HMO) performance. Model choice significantly impacts efficiency findings, cautioning against using them for benchmarking or rate-setting without considering methodological limitations.
Area of Science:
- Health Services Research
- Health Economics
- Management Science
Background:
- Health maintenance organizations (HMOs) are key players in healthcare delivery.
- Assessing the efficiency of HMOs is crucial for resource allocation and performance evaluation.
- Existing efficiency models may produce divergent results, impacting their practical application.
Purpose of the Study:
- To evaluate the efficiency of health maintenance organizations (HMOs).
- To test the robustness of efficiency findings across different analytical models.
- To determine if parallel models using the same data yield consistent insights.
Main Methods:
- Utilized a dataset of 585 HMOs from 1985-1994, including enrollment, utilization, and financial data.
- Computed three distinct efficiency estimates for each HMO.
- Regressed efficiency estimates against case mix, quality, and other relevant factors.
Main Results:
- All models identified similar overall trends for the HMO industry.
- Significant differences were observed in the assessment of individual HMO technical efficiency across models.
- Model selection influenced the identification of efficient firms, potentially overshadowing actual performance.
Conclusions:
- The choice of efficiency estimation technique critically affects study outcomes.
- Findings highlight limitations for using these models in benchmarking or rate-setting.
- Discrepancies across models serve as a warning to interpret research conclusions cautiously.
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