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Do HMOs Make a Difference?
Comparing Access, Service Use and Satisfaction Between Consumers in HMOs and Non-HMOs
Linda Bilheimer, Ph.D.
Janet Corrigan, Ph.D.
Robert Reischauer, Ph.D.
Paul Ginsburg, Ph.D.
Peter Kemper, Ph.D.
James Reschovsky, Ph.D.
ealth maintenance organizations (HMOs) are largely seen by the public as offering lower quality of care than other types of health insurance, principally due to concerns about constrained provider choice, reduction in access to services and other factors. These concerns have contributed to the managed care backlash and calls for patients rights legislation.
To provide context for policy discussions about the future of HMOs, the Center for Studying Health System Change (HSC) recently completed comprehensive research on 35,000 privately insured individuals, comparing those in HMOs with those in other kinds of plans. The results suggest that although reliance on specialists and types of access problems differ between HMOs and other plans, overall access to services does not. Despite this, consumers continue to perceive HMOs as offering somewhat lower-quality care.
Some results highlight well-known differences between how care is delivered in HMOs and other plans. However, other results suggest that conventional wisdom about how care is delivered in these different types of plans may be unfounded.
HSC researchers will begin the conference by presenting their nationally representative findings. A roundtable of experts comprising a whos who of health care policy makers will then discuss the policy ramifications of the studys conclusions. The exchange will focus on the facts and fiction surrounding HMOs, as informed by the study results and other research. Panelists will grapple with issues raised by the study, including:
Following the roundtables reactions to the research findings and debate of issues raised by the results, the discussion will be opened to the audience for an extensive question-and-answer period. Conference attendees will have an opportunity to ask the study co-authors about their findings and pose additional questions to the roundtable participants. Attendees will also receive the first copy of this research, which is being published in six separate papers in the winter issue of Inquiry.
Who Should Attend:
Policy makerswho would like a better understanding of the successes, failures and future of HMOs
Industry leaderslooking for strategic insights into how HMOs compare to other plans and for more informed responses to consumer backlash
Advocateswho are seeking to understand how HMOs and other plans compare on key dimensions Researchers looking for comprehensive, current, nationally representative data that compare HMOs to other plans on a range of objective and subjective measures