This paper assesses the effectiveness of HMOs (Health Maintenance Organizations) in the delivery of health care to poor and low-income communities.
Written in 2002; 8,018 words; 42 sources; APA; $ 172.95
Paper Summary:
This paper presents an extensive review of the effects of HMOs to medical care in the U.S. and England. This paper concludes that HMOs demonstrated that they can be effective in the delivery of health care to any population group, including poor communities and low-income persons and households who live outside of poor communities. The author states that HMOs and other managed care organizations have in the past, are now and likely will continue in the future to sacrifice the care required by any population group that threatens to impinge on the bottom-line of these organizations.
Table of Contents
Introduction
Statement of the Problem
Research Questions
HMOs as Health Care Providers
Access to Care through HMOs
Effects of HMOs and Managed Care on Hospitals and Low-Income Patients
Capitation
Purchaser-Oriented Management and Practice Guidelines
Case Management
Performance Analysis
Medicaid and HMOs: A Direct Impact on Poor Communities and On Low-Income Persons and Households
HMOs and Care Quality
Health Care Delivery in the United States Compared With the United Kingdom
National Health Care System in the UK
Similarities & Differences between the National Health Care Systems in the United Kingdom and the United States
The Case for Universality
Conclusions
From the Paper:
"Over the past 50 years, managed care programs have existed such as the Kaiser Permanente Medical Care Program (California) and the Health Insurance Plan of New York City. These programs only affected a minority of patients and physicians, until the past six or seven years during which managed care has grown significantly. Rising costs of health care, particularly in industry, and the fact that approximately 15 percent of the United States population lacks health insurance, have provided stimulus for this growth. Health care expenditures account for over 14 percent of the gross domestic product in the United States. Management of medical services is attempted through managed care. It is estimated that around 100 million individuals are now covered by a managed care plan and that 77 percent of employers offer a managed care program."
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