Comparing Risk and Costs Contracts
Siddharthan K, Reid W M

International Journal of Health Care Quality Assurance, (UK), Vol 11 No 2 98 Start page: 45 No of pages: 5

Explains how older people, who are Medicare beneficiaries in the USA, are being encouraged enrol in Health Maintenance Organizations (HMOs) and looks at the use of risk and cost contracts as part of the health care prepayment plans. Compares the outpatient and inpatient care received by the Medicare beneficiaries, whose care is based on the different types of contract, to find out if there are any differences. Also analyses if any differences in the care can be ascribed to Health Maintenance Organization characteristics, such as enrolment, number of years in operation, whether they were for-profit or not, accreditation status, type of contract the patient is enrolled in and the organization of the plan. Concludes that the Medicare costs contracts show signs of unmanaged care and over utilization. Argues that there needs to be more research into cost and quality issues to inform the debate on Medicare reform.

Subject(s): HEALTH CARE, MEDICARE, CONTRACTS, SERVICE QUALITY, OLDER PEOPLE, USA
Database: MQA: Management of Quality Abstracts
Style: Theoretical with application in practice, Survey
Indicators: Research Implication- **, Practice Implication- **, Originality- *, Readability- *, Total Number- ****** Reference: 27AG264
Reproduced by permission of Anbar Management Intelligence
http://www.anbar.co.uk/management/home.htm