Researchers from the Johns Hopkins University School of Hygiene and Public Health examined the mix of services provided to consumers enrolled in alternative types of managed-care plans.
They looked specifically at the point-of-service (POS) model, which gives enrollees the option to seek covered services from non-network providers.
The project was part of the Robert Wood Johnson Foundation (RWJF) national program Generalist Provider Research Initiative.
Key Findings: In an article in the Journal of the American Medical Association and a series of reports, the investigators highlighted the following findings:
- Relatively small numbers of enrollees in POS models exercised their self-referral options—a key feature of POS plans.
- Self-referral was related to several factors:
- Size of the provider.
- Presence of chronic disease.
- Belief that the individual rather than the physician is responsible for arranging care.
- Low level of satisfaction with the quality of specialists in the network.
- Poor relationships with network primary care physicians.
- Expenditures in POS plans were equivalent to those in other HMO plans but significantly lower than with those in fee-for-service models.
Generalist Provider Research Initiative Project Results
Individual project results from the RWJF national program, Generalist Provider Research InitiativeRead the Program Results for Generalist Provider Research Initiative
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