You are seeing this message because your Web browser does not support basic Web standards. Find out more about why this message is appearing and what you can do to make your experience on this site better.


ABOUT JAMA
Advanced Search

Welcome   | My Account | E-mail Alerts | Access Rights | Sign In


  Vol. 271 No. 19, May 18, 1994 TABLE OF CONTENTS
  JAMA
  •  Online Features
  Review
 This Article
 •References
 •Full text PDF
 •Send to a friend
 • Save in My Folder
 •Save to citation manager
 •Permissions
 Citing Articles
 •Citation map
 •Citing articles on HighWire
 •Contact me when this article is cited
 Related Content
 •Similar articles in JAMA
 Social Bookmarking
  Add to CiteULike Add to Connotea Add to Del.icio.us Add to Digg Add to Reddit Add to Technorati Add to Twitter What's this?

Managed Care Plan Performance Since 1980

A Literature Analysis

Robert H. Miller, PhD; Harold S. Luft, PhD

JAMA. 1994;271(19):1512-1519.


Abstract

Objective.
—To compare the health care utilization, expenditure, quality of care, and satisfaction since 1980 of enrollees in managed care and indemnity plans.

Data Sources and Study Selection.
—Studies selected met the following criteria: data from 1980 forward, private insurance or Medicare enrollees, a comparison group, a reasonable attempt at statistical adjustment for noncomparable managed care and indemnity plan enrollees, and peer-reviewed findings (with two exceptions). Few studies on preferred provider organization plan performance met the selection criteria.

Data Synthesis.
—Compared with indemnity plans, health maintenance organization plans had somewhat lower hospital admission rates, 1% to 20% shorter hospital length of stay, the same or more physician office visits per enrollee, less use of expensive procedures and tests, greater use of preventive services, mixed results on outcomes, and somewhat lower enrollee satisfaction with services but higher satisfaction with costs. The evidence does not support the hypothesis that prepaid group practice or staff model health maintenance organizations are more effective than individual practice association or network model health maintenance organizations.

Conclusions.
—Although this literature analysis found several clear patterns of results, several factors, including unmeasured selection bias, diverse and rapidly changing health plans and local market conditions, and relatively few research results, suggest that generalizations must be made with caution.

(JAMA. 1994;271:1512-1519)



Author Affiliations

From the Institute for Health & Aging (Dr Miller) and the Institute for Health Policy Studies (Dr Luft), University of California—San Francisco.


Footnotes

Reprint requests to University of California—San Francisco, Institute for Health & Aging, Box 0646, Laurel Heights, San Francisco, CA 94143 (Dr Miller).



Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Market-Based Disparities in Foster Care Service Provision
McBeath and Meezan
Research on Social Work Practice 2008;18:27-41.
ABSTRACT  

Quality of Care in Medicaid Managed Care and Commercial Health Plans
Landon et al.
JAMA 2007;298:1674-1681.
ABSTRACT | FULL TEXT  

State Medicaid Managed Care Enrollment: Understanding the Political Calculus That Drives Medicaid Managed Care Reforms
Pracht
Journal of Health Politics, Policy and Law 2007;32:685-731.
ABSTRACT  

Differences in Prescription Drug Use in HMO and Self-insured Health Plans
Wallack et al.
Med Care Res Rev 2007;64:98-116.
ABSTRACT  

Breast Cancer Treatment of Older Women in Integrated Health Care Settings
Enger et al.
JCO 2006;24:4377-4383.
ABSTRACT | FULL TEXT  

Effect of Physician Reimbursement Methodology on the Rate and Cost of Cataract Surgery
Shrank et al.
Arch Ophthalmol 2005;123:1733-1738.
ABSTRACT | FULL TEXT  

An Empirical Assessment of High-Performing Medical Groups: Results from a National Study
Shortell et al.
Med Care Res Rev 2005;62:407-434.
ABSTRACT  

Health Expenditures for Privately Insured Adults Enrolled in Managed Care Gatekeeping vs Indemnity Plans
Pati et al.
AJPH 2005;95:286-291.
ABSTRACT | FULL TEXT  

Barriers To Constraining Health Care Cost Growth
Chernew et al.
Health Aff (Millwood) 2004;23:122-128.
ABSTRACT | FULL TEXT  

Health Plans' Strategies To Control Prescription Drug Spending
Wallack et al.
Health Aff (Millwood) 2004;23:141-148.
ABSTRACT | FULL TEXT  

Penetrating the "Black Box": Financial Incentives for Enhancing the Quality of Physician Services
Conrad and Christianson
Med Care Res Rev 2004;61:37S-68S.
ABSTRACT  

Expanding Insurance Coverage Through Tax Credits, Consumer Choice, and Market Enhancements: The American Medical Association Proposal for Health Insurance Reform
Palmisano et al.
JAMA 2004;291:2237-2242.
ABSTRACT | FULL TEXT  

Use of Preventive Services by Men Enrolled in Medicare+Choice Plans
Morales et al.
AJPH 2004;94:796-802.
ABSTRACT | FULL TEXT  

Quality Incentives: The Case Of U.K. General Practitioners
Smith and York
Health Aff (Millwood) 2004;23:112-118.
ABSTRACT | FULL TEXT  

Are Healthier Older Adults Choosing Managed Care?
Jensen and Morrisey
Gerontologist 2004;44:85-94.
ABSTRACT | FULL TEXT  

Do HMOs Affect Educational Disparities In Health Care?
Fiscella et al.
Ann Fam Med 2003;1:90-96.
ABSTRACT | FULL TEXT  

The Quality of Health Care Delivered to Adults in the United States
McGlynn et al.
NEJM 2003;348:2635-2645.
ABSTRACT | FULL TEXT  

Does Gatekeeping Control Costs for Privately Insured Children? Findings From the 1996 Medical Expenditure Panel Survey
Pati et al.
Pediatrics 2003;111:456-460.
ABSTRACT | FULL TEXT  

The Implications of Regional Variations in Medicare Spending. Part 1: The Content, Quality, and Accessibility of Care
Fisher et al.
ANN INTERN MED 2003;138:273-287.
ABSTRACT | FULL TEXT  

Defining the Future of Primary Care: What Can We Learn from Patients?
Safran
ANN INTERN MED 2003;138:248-255.
ABSTRACT | FULL TEXT  

Job-Based Health Benefits In 2002: Some Important Trends
Gabel et al.
Health Aff (Millwood) 2002;21:143-151.
ABSTRACT | FULL TEXT  

HMO Performance: The Debate Goes On
Sullivan et al.
Health Aff (Millwood) 2002;21:303-305.
FULL TEXT  

Why Is There A Quality Chasm?
Newhouse
Health Aff (Millwood) 2002;21:13-25.
ABSTRACT | FULL TEXT  

HMO Plan Performance Update: An Analysis Of The Literature, 1997-2001
Miller and Luft
Health Aff (Millwood) 2002;21:63-86.
ABSTRACT | FULL TEXT  

Managed Care and Public Health: Conflict and Collaboration
Rosenbaum and Kamoie
J Law Med Ethics 2002;30:191-200.
 

Consumer Beliefs and Health Plan Performance: It's Not Whether You Are in an HMO but Whether You Think You Are
Reschovsky et al.
Journal of Health Politics, Policy and Law 2002;27:353-378.
ABSTRACT  

The Use of Expensive Health Technologies in the Era of Managed Care: The Remarkable Case of Neonatal Intensive Care
Friedman et al.
Journal of Health Politics, Policy and Law 2002;27:441-464.
ABSTRACT  

Primary Care Quality in the Medicare Program: Comparing the Performance of Medicare Health Maintenance Organizations and Traditional Fee-for-Service Medicare
Safran et al.
Arch Intern Med 2002;162:757-765.
ABSTRACT | FULL TEXT  

Effects of Tennessee Medicaid Managed Care On Obstetrical Care and Birth Outcomes
Conover et al.
Journal of Health Politics, Policy and Law 2001;26:1291-1324.
ABSTRACT  

For-Profit And Not-For-Profit Health Plans Participating In Medicaid
Landon and Epstein
Health Aff (Millwood) 2001;20:162-171.
ABSTRACT | FULL TEXT  

Risk Sharing Between Competing Health Plans And Sponsors
van Barneveld et al.
Health Aff (Millwood) 2001;20:253-262.
ABSTRACT | FULL TEXT  

Economic Grand Rounds: The Costs of Parity Mandates for Mental Health and Substance Abuse Insurance Benefits
Sing and Hill
Psychiatr. Serv. 2001;52:437-440.
FULL TEXT  

Access to Care and Functional Status Change Among Aged Medicare Beneficiaries
Porell and Miltiades
Journals of Gerontology Series B: Psychological Sciences and Social Science 2001;56:69S-83.
ABSTRACT | FULL TEXT  

Patients And Profits: The Relationship Between HMO Financial Performance And Quality Of Care
Born and Simon
Health Aff (Millwood) 2001;20:167-174.
ABSTRACT | FULL TEXT  

Health Plan Characteristics And Consumers' Assessments Of Quality
Landon et al.
Health Aff (Millwood) 2001;20:274-286.
ABSTRACT | FULL TEXT  

Laboratory testing under managed care dominance in the USA
Takemura and Beck
J. Clin. Pathol. 2001;54:89-95.
ABSTRACT | FULL TEXT  

The Impact of Practice Setting on Physician Perceptions of the Quality of Practice and Patient Care in the Managed Care Era
Chehab et al.
Arch Intern Med 2001;161:202-211.
ABSTRACT | FULL TEXT  

Current and Projected Workforce Requirements for Care of the Critically Ill and Patients With Pulmonary Disease: Can We Meet the Requirements of an Aging Population?
Angus et al.
JAMA 2000;284:2762-2770.
ABSTRACT | FULL TEXT  

Management of multiple sclerosis across managed care and fee-for-service systems
Vickrey et al.
Neurology 2000;55:1341-1349.
ABSTRACT | FULL TEXT  

Assessing the Relationship between Quality of Care and the Characteristics of Health Care Organizations
Dudley et al.
Med Care Res Rev 2000;57:116-135.
ABSTRACT  

The Past, Present, and Future of Long-Term Care -- A Women's Issue?
Weinberg
Journal of Health Politics, Policy and Law 2000;25:566-582.
 

Hmos and Health Externalities: A Local Public Good Perspective
Goodman and Stano
Public Finance Review 2000;28:247-269.
ABSTRACT  

Improving Outpatient Diabetes Management Through a Collaboration of Six Competing, Capitated Medicare Managed Care Plans
Marshall et al.
American Journal of Medical Quality 2000;15:65-71.
ABSTRACT  

Organizational and Financial Characteristics of Health Plans: Are They Related to Primary Care Performance?
Safran et al.
Arch Intern Med 2000;160:69-76.
ABSTRACT | FULL TEXT  

Timeliness and Quality of Care for Elderly Patients With Acute Myocardial Infarction Under Health Maintenance Organization vs Fee-for-Service Insurance
Soumerai et al.
Arch Intern Med 1999;159:2013-2020.
ABSTRACT | FULL TEXT  

Physician Intention to Recommend Complete Diagnostic Evaluation in Colorectal Cancer Screening
Myers et al.
Cancer Epidemiol. Biomarkers Prev. 1999;8:587-593.
ABSTRACT | FULL TEXT  

Proactive Measures Needed for Health Care Reform
Erwin and Feldman
Arch Intern Med 1999;159:1370-1371.
FULL TEXT  

Health Care Reform at the Close of the 20th Century
Blumenthal
NEJM 1999;340:1916-1920.
FULL TEXT  

A Revival of Paul Dudley White : An Overview of Present Medical Practice and of Our Society
Favaloro
Circulation 1999;99:1525-1537.
FULL TEXT  

Stage at Diagnosis and Treatment Patterns Among Older Women With Breast Cancer: An HMO and Fee-for-Service Comparison
Riley et al.
JAMA 1999;281:720-726.
ABSTRACT | FULL TEXT  

Association of Managed Care Market Share and Health Expenditures for Fee-for-Service Medicare Patients
Baker
JAMA 1999;281:432-437.
ABSTRACT | FULL TEXT  

Hitting the "Target" in Health Care Cost Control
Cohen
Journal of Health Politics, Policy and Law 1999;24:697-703.
 

Why Are Physicians So Upset about Managed Care?
Luft
Journal of Health Politics, Policy and Law 1999;24:957-966.
 

ISO Quick Fix, Free Lunch, and Share of Pie
Gold
Journal of Health Politics, Policy and Law 1999;24:973-983.
 

The Who, What, and How of Managed Care
McLaughlin
Journal of Health Politics, Policy and Law 1999;24:1045-1049.
 

A Balanced Framework for Change
Mechanic
Journal of Health Politics, Policy and Law 1999;24:1107-1114.
 

Managed Care and Medical Injury: Let's Not Throw Out the Baby with the Backlash
Bovbjerg and Miller
Journal of Health Politics, Policy and Law 1999;24:1145-1157.
 

Mental Disorders and Access to Medical Care in the United States
Druss and Rosenheck
Am. J. Psychiatry 1998;155:1775-1777.
ABSTRACT | FULL TEXT  

Managed Care for Elderly People: A Compendium of Findings
Miller et al.
American Journal of Medical Quality 1998;13:127-140.
ABSTRACT  

Managed Care, Medical Technology, and Health Care Cost Growth: A Review of the Evidence
Chernew et al.
Med Care Res Rev 1998;55:259-288.
ABSTRACT  

Effects of Managed Care on Physician-Patient Relationships, Quality of Care, and the Ethical Practice of Medicine: A Physician Survey
Feldman et al.
Arch Intern Med 1998;158:1626-1632.
ABSTRACT | FULL TEXT  

Physical Health, Depressive Symptoms, and Managed Care Enrollment
Druss et al.
Am. J. Psychiatry 1998;155:878-882.
ABSTRACT | FULL TEXT  

Developing a Tool for Analyzing Medical Care Utilization of Adult Asthma Patients in Indemnity and Managed Care Plans: Can an Episodes of Care Framework Be Used?
Rosen and Mayer-Oakes
American Journal of Medical Quality 1998;13:203-212.
ABSTRACT  

Managed Care and Outcomes of Hospitalization Among Elderly Patients With Congestive Heart Failure
Ni et al.
Arch Intern Med 1998;158:1231-1236.
ABSTRACT | FULL TEXT  

The Effect of Managed Care on Quality: A Review of Recent Evidence
Hellinger
Arch Intern Med 1998;158:833-841.
ABSTRACT | FULL TEXT  

Child Health Care in Changing Times
Leslie et al.
Pediatrics 1998;101:746-752.
ABSTRACT | FULL TEXT  

Does Dissatisfaction with Access to Specialists Affect the Desire to Leave a Managed Care Plan?
Kerr et al.
Med Care Res Rev 1998;55:59-77.
ABSTRACT  

Protecting Patient Welfare in Managed Care: Six Safeguards
Emanuel and Goldman
Journal of Health Politics, Policy and Law 1998;23:635-659.
ABSTRACT  

The Functions and Limitations of Trust in the Provision of Medical Care
Mechanic
Journal of Health Politics, Policy and Law 1998;23:661-686.
ABSTRACT  

Quality of Neurological Care: Balancing Cost Control and Ethics
Bernat
Arch Neurol 1997;54:1341-1345.
ABSTRACT  

Managed Care Regulation: In the Laboratory of the States
Miller
JAMA 1997;278:1102-1109.
ABSTRACT  

Perioperative Management of Colon Cancer Under Medicare Risk Programs
Retchin et al.
Arch Intern Med 1997;157:1878-1884.
ABSTRACT  

Medicaid Managed Care in Texas: What Have We Learned from the Pilots?
Begley et al.
Eval Health Prof 1997;20:302-323.
ABSTRACT  

Outcomes of Stroke Patients in Medicare Fee for Service and Managed Care
Retchin et al.
JAMA 1997;278:119-124.
ABSTRACT  

Managed care: Implications of managed care for health systems, clinicians, and patients
Fairfield et al.
BMJ 1997;314:1895-1895.
ABSTRACT | FULL TEXT  

Managed Care as a Target of Distrust
Mechanic
JAMA 1997;277:1810-1811.
ABSTRACT  

Women's Use of Preventive Screening Services: A Comparison of HMO versus Fee-for-Service Enrollees
Weinick and Beauregard
Med Care Res Rev 1997;54:176-199.
ABSTRACT  

A Comparison of Physician and Hospital Use among the Nonelderly Covered by HMOs and Indemnity Insurance
Fama and Bernstein
Med Care Res Rev 1997;54:239-254.
ABSTRACT  

Do We Understand the Effects of 'Managed Care' in Ophthalmology? A Review and Analysis
Asch et al.
Arch Ophthalmol 1997;115:531-536.
ABSTRACT  

Quality and the Medical Marketplace
Lewis et al.
NEJM 1997;336:807-809.
FULL TEXT  

Dissatisfaction and Disenrollment in a Subsidized Managed Care Program
Patrick et al.
Med Care Res Rev 1997;54:61-79.
ABSTRACT  

Managed Care, Managing Uncertainty
Mirvis and Chang
Arch Intern Med 1997;157:385-388.
ABSTRACT  

Managed Care and Medicare Reform
Oberlander
Journal of Health Politics, Policy and Law 1997;22:595-631.
ABSTRACT  

The Resurgence of Selective Contracting Restrictions
Marsteller et al.
Journal of Health Politics, Policy and Law 1997;22:1133-1189.
ABSTRACT  

The Elderly and Poor in the Medical Outcomes Study
Grana et al.
JAMA 1996;276:1952-1953.
ABSTRACT  

The HMO Backlash -- Righteous or Reactionary?
Bodenheimer
NEJM 1996;335:1601-1604.
FULL TEXT  

The Oregon Capitation Initiative: Lessons and Warnings, From the Forefront of the Backlash
Wynia
JAMA 1996;276:1441-1444.
ABSTRACT  

Payment by Capitation and the Quality of Care- Part Five of Six
Berwick
NEJM 1996;335:1227-1231.
FULL TEXT  

Differences in 4-Year Health Outcomes for Elderly and Poor, Chronically III Patients Treated in HMO and Fee-for-Service Systems: Results From the Medical Outcomes Study
Ware et al.
JAMA 1996;276:1039-1047.
ABSTRACT  

Health Care Utilization and Outcomes Among Persons With Rheumatoid Arthritis in Fee-for-Service and Prepaid Group Practice Settings
Yelin et al.
JAMA 1996;276:1048-1053.
ABSTRACT  

Decline in Hospital Utilization and Cost Inflation Under Managed Care in California
Robinson
JAMA 1996;276:1060-1064.
ABSTRACT  

The Effect of Managed Care on ICU Length of Stay: Implications for Medicare
Angus et al.
JAMA 1996;276:1075-1082.
ABSTRACT  

The Impact of Financial Incentives on Physician Behavior in Managed Care Plans: A Review of the Evidence
Hellinger
Med Care Res Rev 1996;53:294-314.
ABSTRACT  

The Bright Future of Cardiothoracic Surgery in the Era of Changing Healthcare Delivery
Grover
Ann. Thorac. Surg. 1996;61:499-510.
ABSTRACT | FULL TEXT  

Diabetes in a Managed Care System
Quickel
ANN INTERN MED 1996;124:160-163.
ABSTRACT | FULL TEXT  

A National Survey of the Arrangements Managed-Care Plans Make with Physicians
Gold et al.
NEJM 1995;333:1678-1683.
ABSTRACT | FULL TEXT  

Outcomes of Patients With Hypertension and Non--insulin-dependentn Diabetes Mellitus Treated by Different Systems and Specialties: Results From the Medical Outcomes Study
Greenfield et al.
JAMA 1995;274:1436-1444.
ABSTRACT  

Economics
Eisenberg
JAMA 1995;273:1670-1671.
ABSTRACT  

Mechanisms for Controlling Costs
Grumbach and Bodenheimer
JAMA 1995;273:1223-1230.
ABSTRACT  

Continuing Care Retirement Communities: Prospects for Reducing Institutional Long-Term Care
Sloan et al.
Journal of Health Politics, Policy and Law 1995;20:75-98.
ABSTRACT  





HOME | CURRENT ISSUE | PAST ISSUES | TOPIC COLLECTIONS | CME | SUBMIT | SUBSCRIBE | HELP
CONDITIONS OF USE | PRIVACY POLICY | CONTACT US | SITE MAP
 
© 1994 American Medical Association. All Rights Reserved.