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Healthcare Management pp 49–66Cite as

Insurance-Based Managed Care Organisations and Products

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Abstract

The Blue Cross and the Blue Shield health plans were the first health insurance plans in the United States. Together with these insurances, the first health maintenance organisations (HMOs) were also formed in the midst of the Great Depression. Some of the pioneering HMOs include the Kaiser Foundation Health Plans (1937), the Group Health Association (organised by the Home Owner’s Loan Corporation in 1937), the Health Insurance Plan (1944) and the Groups Health Cooperative of Puget Sound (1947). The basic structure of independent practice association (IPA) model HMOs was developed as competition for the group-practice-based HMOs in 1954.

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Notes

  1. 1.

    It should be emphasised that CDHP is only a rudimentary form of insurance with limited risk pooling. However, as for example Schreyögg (2003) argues, savings are also a form of risk coverage. It is therefore justified to call CDHP a form of insurance.

  2. 2.

    This prompted Uwe E. Reinhardt from Princeton University to write an amusing (though probably fictitious) anecdote in the Economix blog of the New York Times. He describes how his wife signs him up for a coloscopy shortly before Christmas in order to use up the remaining available balance in his FSA (see U. E. Reinhardt: The Trouble with (In)flexible Spending Accounts: https://economix.blogs.nytimes.com/2009/05/29/the-trouble-with-flexible-spending-accounts/).

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Authors and Affiliations

  1. Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany

    Volker Eric Amelung

  2. Institute of Health Sciences Research INAV GmbH, Berlin, Germany

    Volker Eric Amelung

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  1. Volker Eric Amelung
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Amelung, V.E. (2019). Insurance-Based Managed Care Organisations and Products. In: Healthcare Management. Springer Texts in Business and Economics. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-59568-8_5

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  • DOI: https://doi.org/10.1007/978-3-662-59568-8_5

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