To understand the effect of health maintenance organizations (HMOs) on both competition and consumers, researchers at the University of Minnesota School of Public Health, Minneapolis, examined data on more than 500 HMOs operating in the United States from 1986 through 1993, focusing on the 90 mergers for which data were available.
A number of national health care reform proposals have prominently featured HMOs in part because of their effectiveness in controlling costs and their acceptance by consumers.
Throughout the 1980s, HMO enrollment increased, reaching 34 million by 1990. At the same time, there was a marketplace consolidation among HMOs.
This project was part of the Robert Wood Johnson Foundation (RWJF) national program Changes in Health Care Financing and Organization (HCFO).
- Smaller and younger HMOs were more likely to merge and exit the market, or fail, while older, larger and more profitable HMOs were more likely to merge and survive.
- Merger activity was highest among two- to four-year-old HMOs.
- An effect on premiums was found only in the most competitive markets.
- Some financially weak HMOs might have failed and left the market if they had not merged into stronger plans.
- Mature HMOs are more difficult to merge because each organization has a distinctive corporate culture.
- Efficiency gains decreased as HMO size increased.
Changes in Health Care Financing and Organization Project Results
Individual project results from the RWJF national program, Changes in Health Care Financing and OrganizationRead the Program Results for Changes in Health Care Financing and Organization View all
Mildred Dalton Manning, the last surviving member of a group of U.S. Army and Navy nurses taken prisoner in the Philippines at the start of ...
Learn how to improve care transitions and prevent avoidable hospital readmissions, and pick up nursing and medical education con-ed credits.
"We often see the benefits of diversity as being for minorities," Angela Amar writes. "We seldom see that the majority benefits as well."
Join the Commission on June 19, 2013 for a public meeting to raise awareness of how non-medical factors influence health and move public- an...
The reconvened Commission to Build a Healthier America will provide new guidance in two key areas: early childhood and healthy communities.
By “practicing” with medical simulation and by interacting with culturally diverse standardized patients, students and residents can develop...
While the need to address disparities in care is well known, few strategies for reducing disparities have been studied systematically.
Team members, grantees, and guests discuss breakthrough ideas that will allow us to move toward solving challenges in health care.
A national conversation highlighting efforts to improve care transitions, reduce avoidable hospital readmissions, and lift overall quality o...
Pioneer Program Officer Lori Melichar discusses using social network insights to solve perplexing health and health care problems.
Legislation Would Dramatically Expand FDA’s Oversight of Compounding Pharmacies - Study: Diners Dramatically Underestimate Calories in Fast ...
Judith Halstead, president of the National League for Nursing, writes about the role of nursing education in realizing a transformed health ...