Word: hmos
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Dates: during 1980-1989
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...decade has seen an explosion in prepaid, "managed" care. More than half of all physicians work in some kind of group practice, most commonly a health-maintenance organization. Patients pay a flat annual fee in exchange for care that is provided by HMO member doctors. As private corporations, many HMOs can be quite profitable -- so long as their patients do not get too sick. The number of patients enrolled in HMOs has doubled in the past five years, to 32 million, often at the urging of cost- conscious employers. The goals: efficiency through greater competition, lower costs, accountability and better...
...remaining 21,872 active physicians, 78.7 percent work in a clinical setting such as hospitals, clinics, HMOs or solo and group practices. Most of the Massachusetts licenseholders practice here, but 18 percent of the clinicians work outside Massachusetts...
...prospective payment" system of such plans requires enrollees to pay a lump sum in advance. Since the HMOs are going to make no more than this fixed amount, "there is strong incentive to keep the patient healthy, to prevent sickness, and to keep the period of care short," he said...
Other panelists supported the idea of integrating HMOs and other plans into Medicare. Prospective payment plans have shortened hospital stays and reduced the number of admissions, said Joseph P. Newhouse '63, a senior fellow of the Rand Corporation...
Though this cost efficiency offered by HMOs is desirable, the reduced access is not, said panelist David Blumenthal, co-chairman of the Harvard Medicare Project...