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Competing HMOs collaborate to improve preventive services

L I Solberg1, G Isham, T E Kottke

  • 1Group Health Foundation, Minneapolis, MN 55440-1309, USA.

The Joint Commission Journal on Quality Improvement
|November 1, 1995
PubMed
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This study tested if a health maintenance organization (HMO) could improve adult preventive care in private clinics. The collaboration demonstrated a model for healthcare delivery reform through quality improvement systems.

Area of Science:

  • Health Services Research
  • Quality Improvement in Healthcare
  • Preventive Medicine

Background:

  • Collaboration between competing managed care plans and primary care clinics.
  • Federally funded research grant (IMPROVE) to test healthcare delivery improvement.
  • Focus on enhancing the delivery of eight adult preventive services.

Purpose of the Study:

  • To scientifically evaluate a health maintenance organization's (HMO) ability to improve preventive service delivery.
  • To test the effectiveness of continuous quality improvement (CQI) and prevention systems.
  • To assess the impact of training and facilitation on contracted private primary clinics.

Main Methods:

  • Randomized controlled trial involving 44 private clinics.
  • Intervention group received train-the-trainer and consultation for CQI.

Related Experiment Videos

  • Comparison group received no intervention; data collected via patient/personnel surveys and chart audits.

    • Main Results:

    • Effectiveness study required structural and functional understanding between two HMOs.
    • Intervention focused on clinics as collaborating customers.
    • Measurement of changes in systems and prevention rates through repeated surveys and audits.

    Conclusions:

    • The project, enabled by unique favorable factors, serves as a potential model for healthcare reform.
    • Highlights the essential role of clinician leadership in achieving true healthcare delivery reform.
    • Demonstrates a viable approach to supporting systemic improvements in primary care settings.