Competition and Regulation: The Selection and Competitive Effects of Health Maintenance Organizations. Volume 1

摘要

The project was designed to address two major research and policy issues concerning Health Maintenance Organizations (HMO's). The first question is how much of the difference in cost and medical care utilization observed for enrollees in HMOs and conventional insurance plans is attributable to the efficiencies of the HMO and how much is attributable to a disproportionate concentration of low utilizing people in HMO's. The second question is to what extent does the growth and development of HMO's cause a competitive response by conventional insurers and providers that results in lower utilization and costs for people not enrolled in HMO's.