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Related Experiment Videos

Do HMOs make a difference?

J D Reschovsky, P Kemper, H T Tu

    Issue Brief (Center for Studying Health System Change)
    |August 1, 2000
    PubMed
    Summary
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    Health Maintenance Organizations (HMOs) offer more primary care and fewer financial barriers but less specialist access. Consumers experience trade-offs, with negligible differences in costly services or unmet needs.

    Area of Science:

    • Health Services Research
    • Managed Care Policy
    • Consumer Health Economics

    Background:

    • The expansion of managed care has raised concerns regarding its impact on consumers.
    • Health Maintenance Organizations (HMOs) are a prominent form of managed care.

    Purpose of the Study:

    • To evaluate the effects of HMOs on consumers within the privately insured population.
    • To compare service utilization, access, and satisfaction between HMOs and other insurance types.

    Main Methods:

    • Analysis of a large national study dataset.
    • Comparison of privately insured individuals enrolled in HMOs versus non-HMO plans.

    Main Results:

    • No significant differences in the utilization of inpatient care, emergency room visits, or surgeries between HMOs and other insurance.

    Related Experiment Videos

  • HMOs showed increased primary and preventive services and reduced financial barriers.
  • HMOs were associated with decreased specialist care access, increased administrative hurdles, and lower patient satisfaction, trust in physicians, and perceived quality of physician visits.

    • Conclusions:

    • HMOs present a trade-off for consumers, balancing increased primary/preventive care and reduced financial barriers against decreased specialist access and administrative burdens.
    • Findings highlight the complex impact of managed care on consumer experience and have implications for policy discussions.
    • While costly service utilization remains similar, patient-reported outcomes and access to specialized care differ significantly.