PEDIATRICS Vol. 62 No. 6 December 1978, pp. 1018
This Article
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by H., R. J.
Right arrow Search for Related Content
PubMed
Right arrow Articles by H., R. J.

CONTRASTS IN HMO AND FEE-FOR-SERVICE PERFORMANCE

R. J. H.

This study compares various aspects of HMO performance in 10 plans with that of the fee-for-service system for the Medicaid population. Additionally, it examines utilization differences between several types of HMO's, grouped according to organization and provider payment. Four areas of behavior were studied—enrollment selectivity, utilization of services, accessibility of care, and satisfaction.

The only significant difference between the two systems was in hospital utilization. Group-practice HMO's had significantly lower hospital utilization than the fee-for-service groups; foundation HMO's did not. This difference seems to indicate that capitation payment to an HMO alone is not significant enough to produce major changes in utilization and that the organized multispecialty group-practice arrangement with largely salaried physicians may be more significant. For the other variables—previous health status, ambulatory-care use (including preventive care), accessibility, and satisfaction-the two groups were remarkably similar.