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![]() ![]() Assessments of Medical Care by Enrollees in For-Profit and Nonprofit Health Maintenance Organizations
April 25, 2002 Abstract:
In the sample of privately insured HMO enrollees as a whole, few differences were found between for-profit and nonprofit HMOs. For-profit HMO enrollees pay 13 percent more for care out-of-pocket and are 10 percent less likely to be very satisfied with their care, but on other key dimensions (e.g., overall barriers to care, trust in physicians), nonprofits and for-profits receive comparable ratings. Among sick enrollees, the for-profit/nonprofit gap in out-of-pocket costs and satisfaction grow larger to 40 percent and 18 percent, respectively. In addition, sick enrollees in for-profit HMOs enrollees rate their physicians lower on all three aspects of physician visits that were surveyed: thoroughness, explanation and listening. In for-profit plans, sick enrollees report more barriers to care, higher out-of-pocket spending, lower ratings of physician listening, and lower trust in physicians to put their medical needs first, as compared to healthy enrollees. In contrast, nonprofit plans show no such deterioration in assessments by sick enrollees relative to healthy enrollees. In fact, sick enrollees of nonprofit plans express greater trust than healthy enrollees that their physicians will put their medical needs first. The findings indicate a divergence between nonprofit and for-profit HMOs in their sick enrollees perceptions of medical care. For-profit HMO enrollees in poor health appear to perceive that they are receiving a lower standard of care. For a full copy, please visit New England Journal of Medicine. |
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