HMOs and the quality of care

Abstract

Various studies of selected health maintenance organizations (HMOs) suggest that the quality of their medical care is comparable to that delivered in the fee-for-service (FFS) sector. Unfortunately, these studies are based on a small number of mature HMOs that were operating in an environment less focused on competition and cost containment than is the case today. It is the thesis of this paper that the current environment increases the importance of quality assessment and assurance for both HMO and FFS providers. I suggest that HMOs may meet the increased demand by patients and payers for quality medical care by focusing attention on population-based outcome measures.