PubMed · 1983 · 70 citations · 10 references
Public AffairsHealth Services AdministrationInsuranceHealth EconomicsHealth InsuranceHealth Services ResearchAmbulatory Care UtilizationHealth Care UtilizationHealth MaintenanceHealth Services UtilizationHealthcare Cost AnalysisHealthcare UtilizationArea CoverageCoverageHealth Care Spending PatternsHealth Care Utilization AnalysisHealth Care Utilization PatternsHealth Maintenance Organization EconomicsHealth Services Utilization PatternsInpatient Resource Use
Inpatient utilization and health care costs of employees and their families were studied for 11 employee groups covered by Blue Cross and Blue Shield in the Minneapolis-St Paul area during the year before optional health maintenance organization (HMO) enrollment. Before enrolling in HMOs, those joining averaged 53% fewer inpatient days (470 days/1,000 v 994 days/1,000) than those retaining fee-for-service (FFS) coverage. Both hospital and professional expenditures were lower among HMO enrollees. Age-specific analysis showed higher inpatient use of continuing FFS subscribers in every category. Self-selection may be an important determinant of differences in use and costs when comparing HMOs with FFS coverage.
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High-Cost Users of Medical Care
Christopher J. Zook, Francis D. Moore · New England Journal of Medicine · 1980 · 350 citations
Assessing the evidence on HMO performance.
Harold S. Luft · PubMed · 1980 · 79 citations
Health Professions, Health Policy, Health Services Administration +17