Health Services for Low-Income Families: Extending Coverage through Prepayment Plans in the Dominican Republic. HFS Technical Report No. 2

摘要

This study explores the potential for extending health services to low-income families in Santo Domingo through private, prepaid HMO type health plans known as Igualas Medicas. Since their founding in the late 1960's and early 1970's, the Igualas have demonstrated impressive growth and increasing market share. The growth has occurred in the lower-end market of minimum wage employees and in mid-size firms and parastatals. Based on a sample of eight Igualas, this report examines the strengths and weaknesses of these prepayment plans as extension mechanisms. Several features of these plans are reviewed: ownership, organization, provider arrangements, benefit packages, premium structures, membership characteristics, and cost containment procedures.