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The New York City-HIP contract.

Journal of the National Medical Association

|November 1, 1979

Summary

The Health Maintenance Organization (HMO) model was applied to 100,000 Medicaid recipients in New York City starting in 1978. Success depended on the city

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Area of Science:

Public Health
Health Services Research
Healthcare Management

Background:

The Health Insurance Plan of New York (HIP) and NYC initiated a large-scale Health Maintenance Organization (HMO) experiment.
This involved enrolling up to 100,000 Medicaid-eligible individuals and families in a prepaid group medical plan.
The initiative began in January 1978, representing a significant application of the HMO concept.

Purpose of the Study:

To assess the feasibility and impact of implementing a large-scale Health Maintenance Organization (HMO) for Medicaid recipients.
To evaluate the adaptability of the City health system to this new model of care delivery.
To understand the role of major health interests in systemwide health planning.

Main Methods:

Implementation of a prepaid group medical plan for 100,000 Medicaid-eligible individuals.
System-level analysis of the City health system's capacity for change.
Engagement with major health stakeholders to foster support and collaboration.

Main Results:

The study represented an unprecedented scale for HMO application in a major urban setting.
The success was contingent on the City health system's adaptability and stakeholder support.
This initiative was a unique effort in rational, systemwide health planning.

Conclusions:

The large-scale implementation of HMOs for Medicaid populations presents significant challenges and opportunities.
Adaptability of existing health systems and collaborative stakeholder engagement are critical for success.
This experiment provided valuable insights into systemwide health planning and managed care models.

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