Effect of a Health Maintenance Organization on Physiologic Health

Results from a Randomized Trial

by Elizabeth M. Sloss, Emmett B. Keeler, Robert H. Brook, Belinda H. Operskalski, George A. Goldberg, Joseph P. Newhouse


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This report, which originally appeared in Annals of Internal Medicine, v. 106, no. 1, January 1987, presents results from analysis of data collected as part of the RAND Health Insurance Experiment. The experiment assessed how cost sharing, as determined by insurance plan, affected patients' use of health services, satisfaction with care, quality of care, and health status. A related purpose was to study how those outcomes were influenced by the type of delivery system, i.e., fee for service or health maintenance organization (HMO). These analysis focus on how the type of delivery system affected measures of health status among persons between 14 and 62 years of age in Seattle, Washington. In numerous comparisons of health status measures between the HMO and the fee-for-service plans, the authors found no strong evidence favoring one system over the other.

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