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Why do HMOs seem to provide more health maintenance services?
The Milbank Memorial Fund Quarterly. Health and Society
|January 1, 1978
Summary
Health maintenance organization (HMO) enrollees use more preventive services, but insurance coverage, not organizational form, drives this. Policy must address financing and prevention ideologies for better health outcomes.
Area of Science:
- Health Services Research
- Public Health Policy
- Preventive Medicine
Background:
- Health maintenance organizations (HMOs) are often perceived to promote greater use of preventive services.
- This perception is frequently attributed to differing organizational philosophies on health maintenance.
Purpose of the Study:
- To investigate the primary drivers of preventive service utilization among health plan enrollees.
- To determine if organizational structure or insurance coverage is more influential.
Main Methods:
- Comparative analysis of preventive service use across different health plan types.
- Statistical examination of the relationship between insurance coverage extent and service utilization.
Main Results:
- The extent of insurance coverage significantly impacts preventive service use more than the health plan's organizational form (e.g., HMO).
- Differences in utilization between HMOs and other plans are less attributable to "health maintenance" philosophies.
Conclusions:
- Insurance coverage is a more critical factor than organizational structure in promoting preventive care.
- Future health policy aiming to improve population health status must re-evaluate current prevention strategies and financing models.
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