The closing of a social HMO: a case study.
A social health maintenance organization (SHMO) integrates acute and long-term care and provides an extended-care benefit for elderly who are at risk of institutionalization. This article reports findings from a case study of the termination of the Group Health SHMO in Minnesota. Interviews were conducted with social workers and at-risk elderly who had been receiving long-term care through the SHMO. The case study examines the post-SHMO transition and the process of replacing SHMO care coordination and longterm care services. Most of the elderly and their caregivers indicated they were "losing ground"--that is, they were paying more or getting less care. Some were paying more for less care. Because they tended to switch to private-pay arrangements and to rely more on informal care, it appears that their care system became much less stable after the closing of the SHMO.
Fischer
L R
LR
HealthPartners Research Foundation, Minneapolis, MN 55440-1309, USA. Lucy.R.Fischer@HealthPartners.com
Leutz
W
W
Miller
A
A
von Sternberg
T L
TL
Ripley
J M
JM
D000368:Aged; D003191:Comprehensive Health Care / Q000458:organization & administration; D006279:Health Maintenance Organizations / Q000458:organization & administration*; D006299:Health Services for the Aged / Q000458:organization & administration; D019456:Health Transition; D006801:Humans; D008910:Minnesota; D019982:Organizational Case Studies; D011787:Quality of Health Care