What question did this study set out to answer?

To evaluate whether managed care plans, particularly health maintenance organizations (HMOs), provide superior or inferior quality of care and resource utilization compared to traditional fee-for-service arrangements.

September 1, 1997Health Affairs

Does Managed Care Lead To Better Or Worse Quality Of Care?

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Authors

RMRobert H. MillerUniversity of California, San Francisco HLHarold S. LuftLee University

Discussion

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Implication

Systematic review reveals mixed quality of care between health maintenance organizations and fee-for-service plans in insured enrollees, indicating neither uniform harms nor clear improvements.

Key Points

To evaluate whether managed care plans, particularly health maintenance organizations (HMOs), provide superior or inferior quality of care and resource utilization compared to traditional fee-for-service arrangements.
Synthesized findings from 37 peer-reviewed health services research studies published prior to the mid-1990s.
Assessed comparative outcomes across clinical quality of care, hospital and physician resource utilization, and enrollee satisfaction.
Across 15 studies evaluating clinical quality, an equal number demonstrated significantly better and significantly worse outcomes in HMOs compared to non-HMO plans.
Medicare HMO enrollees with chronic conditions exhibited worse quality of care across multiple analyses, while overall physician and hospital resource use revealed no consistent pattern.
Enrollee satisfaction varied substantially depending on the specific metric and enrollee subgroup, demonstrating that claims of universal harm or broad improvement remain unsupported.

Cite This Study

Miller et al. (1997) studied this question.

synapsesocial.com/papers/6a10f6f78102eb4b66eecbad https://doi.org/10.1377/hlthaff.16.5.7

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Implication

Systematic review reveals mixed quality of care between health maintenance organizations and fee-for-service plans in insured enrollees, indicating neither uniform harms nor clear improvements.

Does Managed Care Lead To Better Or Worse Quality Of Care?

Discussion

Member takes

Implication

Key Points

Cite This Study

Does Managed Care Lead To Better Or Worse Quality Of Care?

Discussion

Member takes

Implication

Key Points

Cite This Study

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Also Consider