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- Title
S/HMO Versus TEFRA HMO Enrollees: Analysis of Expenditures.
- Authors
Dowd, Bryan; Hillson, Steve; VonSternberg, Tom; Fischer, Lucy Rose
- Abstract
This study compares expenditures on health care services for enrollees in a social health maintenance organization (S/HMO) and a Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA)-risk Medicare health maintenance organization (HMO). In addition to the traditional Medicare services covered by the TEFRA HMO, the S/HMO provided a long-term care (LTC) benefit and case management services for chronic illness. There do not appear to be any overall savings associated with S/HMO membership, including any savings from substitution of S/HMO-specific services for other, traditional services covered by both the S/HMO and the TEFRA HMO.
- Subjects
MEDICAL care; SOCIAL health maintenance organizations; HEALTH maintenance organizations; ADMINISTRATIVE acts; HOSPITAL case management services; CHRONIC diseases
- Publication
Health Care Financing Review, 1999, Vol 20, Issue 4, p7
- ISSN
0195-8631
- Publication type
Article