The variations in health maintenance organization (HMO) and Medicaid mortality and preventable readmissions

Date of Award

1997

Document Type

Thesis

Degree Name

Master of Science in Health Services Administration

Department

Health Science and Human Ecology

Abstract

The rising costs of health care and burgeoning government deficits have prompted new ways to control costs, while continuing to provide necessary health care. One method increasingly chosen by states to achieve these objectives is managed health care. There are many forms of managed care organization today. There are HMOs that provide the financing and delivery systems under the control of a single for-profit or non-profit organization; preferred provider organizations consisting of providers that have a pre-negotiated and usually discounted rate for services; administration service organizations that provide claims adjudication; and managed indemnity services organizations that use case management to control costs, while providing beneficiary freedom of choice.

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