Selection bias in HMOs and PPOs: a review of the evidence

Article Abstract:

Health maintenance organizations (HMO) and preferred provider organizations (PPO) attract more enrollees who are healthy among the nonelderly population. A study of the persons who seek care from providers suggest that selection effects determined whether individuals will enroll in an HMO or PPO. It was shown that individuals who declined 'first-time-offers' to join provider organizations were most likely to enroll at the next possible opportunity. It was also shown that HMOs and PPOs that have good reputations experience favorable selection among both nonelderly and elderly enrollees.

Preferred provider organizations (Medical care)

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The impact of non-IPA HMOs on the number of hospitals and hospital capacity

Article Abstract:

A study has been conducted to determine the effects of managed care on the demand for hospital services. It is predicted that hospitals that rely on managed care will have reduced number of enrollees because managed care plans deliver a different style of care, despite having lower costs. On the other hand, the growth of managed care in the health care market is expected to reduce hospital occupancy. A study presenting the relationship between managed care and hospital occupancy rates using the Standard Metropolitan Statistical Area data is discussed.

Analysis, Medical care utilization, Managed care plans (Medical care), Hospital utilization

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Do HMOs make a difference? Consumer assessments of health care

Article Abstract:

The effects of health maintenance organizations on evaluation of health care services by patients are analyzed. Additional information on mathematical models use to analyze consumers' assessment of health care services is also included.

United States, Services

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