HMOs Surpass Traditional Insurance in Eliminating Some Disparities

Analysis of the impact of HMOs on racial and socioeconomic disparities in health care among the insured - Health Tracking Joint Solicitation

In this 2000 project, Kevin Fiscella, MD, MPH, and researchers at the University of Rochester, examined the effect of managed care penetration on socioeconomic and racial/ethnic disparities in health care.

They hypothesized that managed care penetration may help alleviate disparities in health care access and quality between different socioeconomic and racial/ethnic populations.

The project was part of the Robert Wood Johnson Foundation (RWJF) Changes in Health Care Financing and Organization (HCFO) national program.

Key Findings

  • HMO enrollees used health care at similar rates regardless of education. Disparities in health care use related to income and to race/ethnicity were similar between HMO enrollees and individuals with indemnity insurance.

  • HMO enrollees were more likely than individuals with indemnity insurance to have received care from a mental health professional.

  • High-income HMO enrollees were significantly more likely to have a usual source of medical care than were high-income individuals with indemnity insurance.

  • According to the principal investigator, "HMOs are doing better than non-HMOs in eliminating disparities, at least as far as they relate to educational factors, but we believe HMOs have untapped potential to address racial and ethnic disparities as well."