HMO's and the Elderly: Hearing Before the Subcommittee on Health and Long-Term Care of the Select Committee on Aging, House of Representatives, Ninety-fifth Congress, Second Session, May 2, 1978United States. Congress. House. Select Committee on Aging. Subcommittee on Health and Long-Term Care U.S. Government Printing Office, 1978 - 147 pages |
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administration ambulatory American Association benefits BIAGGI bill California Chairman CHAMPION Clackamas County CLAUDE PEPPER clinics COHEN coinsurance committee compared comprehensive CONGRESS THE LIBRARY copayments costs County coverage CRUIKSHANK delivery doctors Donabedian DRINAN elderly enrollees enrollment expenditures Federal fee-for-service Group Health HARWITZ Health and Society health insurance health insurance plans health maintenance organizations health services HMO concept HMO-type plans HMO's home health hospital utilization incentives independent practice association Kaiser-Permanente Klarman LIBRARY OF CONGRESS lower M M F Q medi Medicaid medical care foundation Medical Group medicare beneficiaries medicare patients medicare program membership ment MMFQ Health nursing older out-of-pocket out-of-pocket expenses patterns payment PEPPER percent persons PGP plans physicians plan-types population premiums prepaid group practice prepayment present problems Public Health rates reimbursement reported require returns to scale Roemer SCHWARTZ Social Security Administration subcommittee Summer tion
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Page 81 - Beattie, an outstanding educator and a professor in the School of Public Health at the University of California, Berkeley, was made an honorary member of the coun-cil.
Page 124 - Prepayment Project. Los Angeles: University of California School of Public Health (January, processed). Gartside, Foline E., and Donald M. Procter 1970 Medicaid Services in California under Different Organizational Modes: Physician Participation in the San Joaquin Prepayment Project. Los Angeles: University of California School of Public Health (January, processed). Glasgow, John M. 1972 "Prepaid group practice as a national health policy: problems and perspectives.
Page 141 - Medicare Trust Funds") as follows : (I) savings up to 20 percent of the adjusted average per capita cost shall be apportioned equally between such organization and the Medicare Trust Funds ; (II) savings in excess of 20 percent of the adjusted average per capita cost shall be apportioned entirely to such Trust Funds; (ii) if the Secretary determines that the per...
Page 138 - The sine qua non of an HMO is prepayment for medical care in contrast to the feefor-service mode's use of postpayment. More specifically, we define an HMO as an organization which accepts contractual responsibility to assure the delivery of a stated range of health services, including at least ambulatory and in-hospital care, to a voluntarily enrolled population in exchange for an advance capitation payment, where the organization assumes at least part of the financial risk or shares in the surplus...
Page 38 - ... Carolina. He then served as Internal Medicine Resident of Boston City Hospital for one year, followed by a year at the National Institute of Health Fellowship in Renal Disease, University of California Hospital (San Francisco, California). Dr. James A. Howenstine has served as an Assistant Clinical Professor of Medicine at the University of California Medical School in San Francisco, California from May 1963 through July 1991 during which time he engaged in a private practice in Internal Medicine....
Page 127 - Peer review in medical foundations: its effect on qualifications of surgeons." Health Services Reports. University of California School of Public Health (December). Roemer, Milton I., Robert W. Hetherington, Carl E. Hopkins, Arthur E. Gerst, Eleanor Parsons, and Donald M. Long 1973 Health Insurance Effects: Services, Expenditures, and Attitudes under Three Types of Plan. Ann Arbor: University of Michigan School of Public Health. MMFQ / Health and Society / Summer 1973 317 Roemcr, Milton I., A. Tahcr...
Page 81 - Eisenberg is a member of the Institute of Medicine of the National Academy of Sciences. He has...
Page 125 - Restructuring the health delivery system — will the health maintenance strategy work?" Pp. 3-11 in Health Maintenance Organizations: A Reconfiguration of the Health Services System. Chicago: Center for Health Administration Studies, University of Chicago.
Page 14 - US would remain, at least to some extent, as an incoherent barrier against state enactment or enforcement of local regulations of the same subject. Would it not be in the public interest as well as in the interest of justice to this petitioner to...
Page 82 - Health maintenance organizations (HMOs) are being promoted as a strategy to modify the US health care delivery system toward more economical patterns, encouraging preventive and ambulatory rather than costly hospital services. Evidence of HMO performance has accumulated over the years, much of it reviewed in 1969. Since then, additional evidence suggests that the prepaid group practice (PGP) model of HMO continues to yield lower hospital use.