Increased supply of HMO providers produces higher utilization

Article Abstract:

A study of health maintenance organization (HMO) enrollment and competition within the industry revealed that the increased number of HMO providers yields increased utilization of their health services. On the other hand, higher HMO competition results in lower health services utilization. The number of specialists served as the leading indicator of utilization. The highest utilization was determined in smaller cities such as Decatur, IL, Florence, AL and San Angelo, TX.

Market share

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Employer managed care liability: defining and managing the risk

Article Abstract:

A California jury's judgment in favor of Nelene Fox, who died of breast cancer in Apr. 1993, changed the way insurers and health maintenance organizations (HMOs) decide whether or not to pay for experimental treatments. Fox's HMO was asked to pay $89 million in damages to her family because its denial of cover for a bone marrow transplant delayed treatment and caused her death. Cases which involve tort liability of employers in the selection of HMOs are also presented.

Cases, Laws, regulations and rules, Respondeat superior

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Making sense of HMO report cards

Article Abstract:

The dominance of health care organizations in employee benefits plans of corporations has made it more crucial for firms to obtain plans which can afford the best value to their employees. Health maintenance organizations (HMOs) have been maligned in the mass media for their alleged inefficiency in providing service. Firms can refer to, with caution, the Health Plan and Employer Data Information Set, which is an exhaustive compilation of HMO report cards.

Management, Evaluation

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