Identifying Available Options

  • Anthony J. Mahler
  • John Friedland
Part of the Industry and Health Care book series (SSIND, volume 5)


The Secretary’s HMO Conference, summarized in appendix I, urged industry to become deeply involved in developing HMOs to help control the nation’s health care costs. But aside from presenting a few case histories of company- or union-sponsored HMOs, the Conference fell short of providing specific plans for action. As a follow-up, the Center for Industry and Health Care and the Massachusetts Society for Internal Medicine sponsored a conference on industry and HMOs in Massachusetts. Drawing in part on comments by participants in the second conference, this chapter identifies various types of HMOs which a company can investigate once the decision has been made to pursue HMO development as an element in its strategy to contain health care costs. At this point in the process, an industry group must examine the health care system in its own community to find which of the possible HMO forms is appropriate for its specific situation. This chapter provides a background for that analysis.


Health Plan Group Practice Hospital Utilization Salaried Group Direct Capitation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Richard H. Egdahl, John Friedland, Anthony J. Mahler, and Diana Chapman Walsh, “Fee-for-Service HMOs,” Journal of the American Medical Association (in press).Google Scholar
  2. 3.
    Robert G. Shouldice and Katherine H. Shouldice, Medical Group Practice and Health Maintenance Organizations ( Washington, D.C.: Information Resources Press, 1978 ).Google Scholar
  3. 4.
    Louis J. Goodman, Edward H. Bennett III, and Richard J. Odem, “Current Status of Group Medical Practice in the United States,” Public Health Reports 92 (5) (September-October 1977): 430–443 (hereafter, Current Status).Google Scholar
  4. 5.
    Cecil C. Cutting, “Historical Development and Operating Concepts,” in The Kaiser Permanente Medical Care Program: A Symposium, Anne R. Somers, ed. ( New York: The Commonwealth Fund, 1971 ), pp. 17–22.Google Scholar
  5. 6.
    Bynum E. Tudor, “A New Corporate Prepaid Group Health Plan,” in Background Papers on Industry’s Changing Role in Health Care Delivery, Richard H. Egdahl, ed., Springer Series on Industry and Health Care, No. 3 ( New York: Springer-Verlag, 1977 ), pp. 70–78.Google Scholar
  6. 7.
    Joseph L. Dorsey, “Prepaid Group Practice and the Delivery of Ambulatory Care,” New England Journal of Medicine 291 (7) (August 15, 1974 ): 361–363.Google Scholar
  7. 8.
    John R. Kress and James Singer, HMO Handbook ( Rockville, Maryland: Aspen Systems Corporation, 1975 ), p. 110.Google Scholar
  8. 9.
    Aaron Wildavsky, “Doing Better and Feeling Worse: The Political Pathology of Health Policy,” DaedaJus, Journal of the American Academy of Arts and Sciences (Winter, 1977 ): 105–123.Google Scholar
  9. 10.
    Harold S. Luft, “How do Health-Maintenance Organizations Achieve Their Savings?” New England Journal of Medicine, 298 (24) (June 15, 1978 ): 1336–1343.Google Scholar
  10. 11.
    Lawrence G. Goldberg and Warren Greenberg, “Staff Report on the Health Maintenance Organization and its Effects on Competition” (Washington, D.C.: Federal Trade Commission, Bureau of Economics, July 1977 ).Google Scholar
  11. 12.
    Seymour Lusterman, Industry Roles in Health Care ( New York: The Conference Board, 1974 ), p. 83.Google Scholar
  12. 15.
    Richard H. Egdahl, et al., “The Potential of Organizations of Fee-for-Service Physicians for Achieving Significant Decreases in Hospitalization,” Annals of Surgery, 186 (1977): 156–167.Google Scholar
  13. 16.
    Jacob J. Spies, A Corporation’s Experience with Independent Practice Association HMOs, in Background Papers on Industry’s Changing Role in Health Care Delivery, Richard H. Egdahl, ed., Springer Series on Industry and Health Care, No. 3 ( New York: Springer-Verlag, 1977 ), pp. 3–15.Google Scholar
  14. 17.
    Lloyd Mathwick and Anthony Masso, “The New Mexico Health Care Corporation: A Discussion of the First Two Years of Operation,” (Rockville, Maryland and Albuquerque, New Mexico: Department of Health, Education, and Welfare, Health Services Administration, Bureau of Community Health Services, Health Maintenance Organizations, and The New Mexico Health Care Corporation, April 15, 1975 ).Google Scholar
  15. 18.
    Remarks by Alfred F. Dougherty, Jr., Director, Bureau of Competition, Federal Trade Commission, at the National Health Lawyers Association Seminar on Antitrust in the Health Care Field, Washington, D.C., December 13, 1977.Google Scholar
  16. 19.
    Alain C. Enthoven, “Shattuck Lecture—Cutting Cost Without Cutting the Quality of Care,” New England Journal of Medicine, 298 (22) (June 1, 1978 ): 1229–1238.Google Scholar
  17. 20.
    Remarks by Edwin C. Brown, Secretary-Treasurer, Rhode Island AFL-CIO, and President, Rhode Island Group Health Association, at the Secretary’s National HMO Conference, Washington, D.C., March 10, 1978.Google Scholar

Copyright information

© Springer-Verlag New York Inc. 1978

Authors and Affiliations

  • Anthony J. Mahler
  • John Friedland

There are no affiliations available

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