We focus on a number of topic areas identified by state health policy leaders as important to population health.
Keep up with news and updates from the Milbank Memorial Fund. Get the latest from thought leaders, including Christopher F. Koller, president of the Fund.
We publish The Milbank Quarterly, as well as reports, issues briefs, and case studies on topics important to population health.
The Center for Evidence-based Policy at Oregon Health & Science University is a national leader in evidence-based decision making and policy design.
The Milbank Memorial Fund is an endowed operating foundation that publishes The Milbank Quarterly, commissions projects, and convenes state health policy decision makers on issues they identify as important to population health.
September 1973 (Volume 51)
September 1973 | Milton I. Roemer, William Shonick
Health maintenance organizations (HMOs) are being promoted as a strategy to modify the U.S. health care delivery system toward more economical patterns, encouraging preventive and ambulatory rather than costly hospital services. Evidence of HMO performance has accumulated over the years, much of it reviewed in 1969. Since then, additional evidence suggests that the “prepaid group practice” (PGP) model of HMO continues to yield lower hospital use, relatively more ambulatory and preventive service, and lower overall costs (counting both premiums and out-of-pocket expenditures) than conventional open-market fee-for-service patterns. Economies of scale in group practice per se are still not proved, but some evidence supports this theoretical hypothesis. New data point to reduced disability from the PGP model of HMO, as well as to more favorable consumer attitudes (based mainly on the economic advantages, in spite of certain impersonalities of clinics) than exist toward conventionally insured private solo practice. The medical care foundation (free choice of private practitioners with fee payments) model of HMO has yielded some evidence of economies in physician’s care, but none in hospital use. HMOs entail hazards of underservicing and distorted risk-selection, but with appropriate public monitoring they constitute an approach to health planning, stressing local initiative, competition, and incentives to self-regulation.
Author(s): Milton I. Roemer; William Shonick
Download the Article
Read on JSTOR
Volume 51, Issue 3 (pages 271–317)
Published in 1973
Some Parameters for Social Policy in Disability: A Cross-National Comparison
Medical Sociology: A Brief Review
Get the Latest from the Milbank Memorial Fund