Access to Care in HMOs and Traditional Insurance Plans

Health Affairs

Volumn 15, Issue 4, 1996, Pages 81-87

  Mark, Tami ^a   Mueller, Curt ^a  

^a Project HOPE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADOLESCENT; ADULT; AMBULATORY CARE; ARTICLE; CHILD; COMPARATIVE STUDY; ECONOMICS; EPIDEMIOLOGY; FEMALE; HEALTH CARE DELIVERY; HEALTH INSURANCE; HEALTH MAINTENANCE ORGANIZATION; HUMAN; INCOME; INFANT; MALE; MIDDLE AGED; PATIENT SATISFACTION; PRESCHOOL CHILD; STANDARD; STATISTICS; UNITED STATES; UTILIZATION REVIEW;

ADOLESCENT; ADULT; AMBULATORY CARE; CHILD; CHILD, PRESCHOOL; FEMALE; HEALTH CARE SURVEYS; HEALTH MAINTENANCE ORGANIZATIONS; HEALTH SERVICES ACCESSIBILITY; HUMANS; INCOME; INFANT; INSURANCE, HEALTH; MALE; MIDDLE AGED; PATIENT SATISFACTION; PREFERRED PROVIDER ORGANIZATIONS; SELECTION BIAS; UNITED STATES;

EID: 0343661614     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.15.4.81     Document Type: Article

References (13)

1. See, for example, R.H. Miller and H.S. Luft, "Managed Care Performance since 1980: A Literature Analysis," Journal of the American Medical Association 271, no. 19 (1994): 1512-1519; D.G. Clement et al., "Access and Outcomes of Elderly Patients Enrolled in Managed Care," Journal of the American Medical Association 271, no. 19 (1994): 1487-1492; R. Newcomer, C. Harrington, and S. Preston, "Satisfaction in the Social/Health Maintenance Organization: A Comparison of Members, Disenrollees, and Those in Fee-for-Service," in HMOs and the Elderly, ed. H.S. Luft (Ann Arbor, Mich.: Health Administration Press, 1994); D.P. Lubeck, B.W. Brown, and H.R. Holman, "Chronic Disease and Health System Performance: Care of Osteoarthritis across Three Health Services," Medical Care 23, no. 3 (1985): 266-277; and K.B. Wells et al., "Detection of Depressive Disorder for Patients Receiving Prepaid or Fee-for-Service Care: Results from the Medical Outcomes Study," Journal of the American Medical Association 262, no. 17 (1989): 3298-3302.
2. See, for example, R.H. Miller and H.S. Luft, "Managed Care Performance since 1980: A Literature Analysis," Journal of the American Medical Association 271, no. 19 (1994): 1512-1519; D.G. Clement et al., "Access and Outcomes of Elderly Patients Enrolled in Managed Care," Journal of the American Medical Association 271, no. 19 (1994): 1487-1492; R. Newcomer, C. Harrington, and S. Preston, "Satisfaction in the Social/Health Maintenance Organization: A Comparison of Members, Disenrollees, and Those in Fee-for-Service," in HMOs and the Elderly, ed. H.S. Luft (Ann Arbor, Mich.: Health Administration Press, 1994); D.P. Lubeck, B.W. Brown, and H.R. Holman, "Chronic Disease and Health System Performance: Care of Osteoarthritis across Three Health Services," Medical Care 23, no. 3 (1985): 266-277; and K.B. Wells et al., "Detection of Depressive Disorder for Patients Receiving Prepaid or Fee-for-Service Care: Results from the Medical Outcomes Study," Journal of the American Medical Association 262, no. 17 (1989): 3298-3302.
3. See, for example, R.H. Miller and H.S. Luft, "Managed Care Performance since 1980: A Literature Analysis," Journal of the American Medical Association 271, no. 19 (1994): 1512-1519; D.G. Clement et al., "Access and Outcomes of Elderly Patients Enrolled in Managed Care," Journal of the American Medical Association 271, no. 19 (1994): 1487-1492; R. Newcomer, C. Harrington, and S. Preston, "Satisfaction in the Social/Health Maintenance Organization: A Comparison of Members, Disenrollees, and Those in Fee-for-Service," in HMOs and the Elderly, ed. H.S. Luft (Ann Arbor, Mich.: Health Administration Press, 1994); D.P. Lubeck, B.W. Brown, and H.R. Holman, "Chronic Disease and Health System Performance: Care of Osteoarthritis across Three Health Services," Medical Care 23, no. 3 (1985): 266-277; and K.B. Wells et al., "Detection of Depressive Disorder for Patients Receiving Prepaid or Fee-for-Service Care: Results from the Medical Outcomes Study," Journal of the American Medical Association 262, no. 17 (1989): 3298-3302.
4. See, for example, R.H. Miller and H.S. Luft, "Managed Care Performance since 1980: A Literature Analysis," Journal of the American Medical Association 271, no. 19 (1994): 1512-1519; D.G. Clement et al., "Access and Outcomes of Elderly Patients Enrolled in Managed Care," Journal of the American Medical Association 271, no. 19 (1994): 1487-1492; R. Newcomer, C. Harrington, and S. Preston, "Satisfaction in the Social/Health Maintenance Organization: A Comparison of Members, Disenrollees, and Those in Fee-for-Service," in HMOs and the Elderly, ed. H.S. Luft (Ann Arbor, Mich.: Health Administration Press, 1994); D.P. Lubeck, B.W. Brown, and H.R. Holman, "Chronic Disease and Health System Performance: Care of Osteoarthritis across Three Health Services," Medical Care 23, no. 3 (1985): 266-277; and K.B. Wells et al., "Detection of Depressive Disorder for Patients Receiving Prepaid or Fee-for-Service Care: Results from the Medical Outcomes Study," Journal of the American Medical Association 262, no. 17 (1989): 3298-3302.
5. See, for example, R.H. Miller and H.S. Luft, "Managed Care Performance since 1980: A Literature Analysis," Journal of the American Medical Association 271, no. 19 (1994): 1512-1519; D.G. Clement et al., "Access and Outcomes of Elderly Patients Enrolled in Managed Care," Journal of the American Medical Association 271, no. 19 (1994): 1487-1492; R. Newcomer, C. Harrington, and S. Preston, "Satisfaction in the Social/Health Maintenance Organization: A Comparison of Members, Disenrollees, and Those in Fee-for-Service," in HMOs and the Elderly, ed. H.S. Luft (Ann Arbor, Mich.: Health Administration Press, 1994); D.P. Lubeck, B.W. Brown, and H.R. Holman, "Chronic Disease and Health System Performance: Care of Osteoarthritis across Three Health Services," Medical Care 23, no. 3 (1985): 266-277; and K.B. Wells et al., "Detection of Depressive Disorder for Patients Receiving Prepaid or Fee-for-Service Care: Results from the Medical Outcomes Study," Journal of the American Medical Association 262, no. 17 (1989): 3298-3302.
6. K. Davis et al., "Choice Matters; Enrollees' Views of Their Health Plans," Health Affairs (Summer 1995): 99-112.
7. J.P. Newhouse and The Insurance Experiment Group, Free for All? Lessons from the Rand Health Insurance Experiment (Cambridge, Mass.: Harvard University Press, 1994).
8. The percentage of persons reporting being in an HMO or a traditional plan is higher than that reported by other surveys. According to Employee Benefit Research Institute (EBRI) estimates (which are based on the 1994 Current Population Survey and data collected by InterStudy), in 1993, 22 percent of privately insured persons were in HMOs, 43 percent were in PPOs, and 33 percent were in indemnity plans. EBRI, Sources of Health Insurance and Characteristics of the Uninsured: Analysis of the March 1994 Current Population Survey, Issue Brief 158 (Washington: EBRI, February 1995). Differences between the EBRI and the RWJF estimates may reflect differences in questionnaire design, as well as a blurring of the distinction between PPOs and other plan types.
9. The multivariate results are available from the authors at Project HOPE, Center for Health Affairs, Suite 600, 7500 Old Georgetown Road, Bethesda, Maryland 20814.
10. See T. Fama, P.D. Fox, and L.A. White, "Do HMOs Care for the Chronically Ill?" Health Affairs (Spring 1995): 234-243; A.K. Taylor, K.M. Beauregard, and J.P. Vistnes, "Who Belongs to HMOs: A Comparison of Fee-for-Service versus HMO Enrollees," Medical Care Research and Review 52, no. 3 (1995): 389-408; and F.L. Hellinger,"Selection Bias in HMOs and PPOs: A Review of the Evidence," Inquiry 32, no. 2 (1995): 135-142.
11. See T. Fama, P.D. Fox, and L.A. White, "Do HMOs Care for the Chronically Ill?" Health Affairs (Spring 1995): 234-243; A.K. Taylor, K.M. Beauregard, and J.P. Vistnes, "Who Belongs to HMOs: A Comparison of Fee-for-Service versus HMO Enrollees," Medical Care Research and Review 52, no. 3 (1995): 389-408; and F.L. Hellinger,"Selection Bias in HMOs and PPOs: A Review of the Evidence," Inquiry 32, no. 2 (1995): 135-142.
12. See T. Fama, P.D. Fox, and L.A. White, "Do HMOs Care for the Chronically Ill?" Health Affairs (Spring 1995): 234-243; A.K. Taylor, K.M. Beauregard, and J.P. Vistnes, "Who Belongs to HMOs: A Comparison of Fee-for-Service versus HMO Enrollees," Medical Care Research and Review 52, no. 3 (1995): 389-408; and F.L. Hellinger,"Selection Bias in HMOs and PPOs: A Review of the Evidence," Inquiry 32, no. 2 (1995): 135-142.
13. Taylor et al., "Who Belongs to HMOs."