The benefits of HMO community benefits programs.
Managed care is becoming the dominant mode of health care coverage, and health maintenance organizations (HMOs) are playing a key role in the delivery of health care within the evolving, cost-competitive system. However, in this cost-cutting arena, do HMOs have responsibility for health services to communities which extends beyond their enrolled populations? Do HMO community benefits programs have significant impact on the uninsured or the related problem of paying for uncompensated care? The Massachusetts Attorney General believed so and developed the first set of voluntary guidelines in the nation for HMOs to follow in developing community benefits programs. This study reports on the initial year of the program and raises important policy questions regarding the responsibility HMOs have to the communities apart from the population they contract with, and the extent to which communities benefit from HMO community benefits programs.
O'Sullivan
M J
MJ
Program in Health Services Administration, College of Health Professions, University of Massachusetts-Lowell, One University Avenue, Lowell, MA 01854, USA.
D018672:Community Health Planning; D003153:Community Health Services / Q000600:supply & distribution*; D003159:Community-Institutional Relations / Q000191:economics / Q000592:standards*; D017408:Guidelines as Topic; D006279:Health Maintenance Organizations / Q000191:economics / Q000592:standards*; D006801:Humans; D008404:Massachusetts; D015397:Program Evaluation; D012941:Social Responsibility