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| Comparing Access, Service Use and Satisfaction Between Consumers in HMOs and Non-HMOs | ||
Do HMOs Make a Difference?
Introduction
Winter 1999/2000
Inquiry, vol.36, no.4 (Winter 1999/2000): 374-377
James D. Reschovsky, Peter Kemper
he study presented in this and the following five papers analyzes how
health maintenance organizations (HMOs) affect privately insured individuals’ access
to health care, use of services, and assessments of care. Using a common data source and
methodology, the study examines differences in a braod range of measures between HMOs and
other types of insurance, controlling for health status and an extensive set of other
individual characteristics and market location. HMO/non-HMO differences also are examined
across population subgroups defined by health status, income, race and age. Data come from
the Community Tracking Study Household Survey, a recent, large national survey. Findings
show that a person’s type of health insurance coverage has little effect on the
likelihood of unmet or delayed needs for medical care in the aggregate, but the types of
access problems faced by HMO and non-HMO enrollees differ. HMO enrollees are less likely
to face financial barriers to care, but more likely to face barriers related to the
organization of care delivery. HMO enrollees use more ambulatory and preventive care, but
results show no differences in hospital, surgery, and emergency room use. Compared with
other types of insurance, physician visits under HMOs are more likely to be to primary
care physicians than to specialists. Finally, across nearly all measures of patients’
satisfaction, ratings of their last doctor’s visit, and trust in their physicians,
HMO enrollees’ assessments of care are lower than those of people not in HMOs. Across
all measure, the study finds few subgroup differences.
For a full copy please visit Inquiry.
