Primary Care Quality in the Medicare Program

Abstract
SINCE 1972, Medicare beneficiaries in many parts of the country have had the option of enrolling in a Medicare-qualified health maintenance organization (HMO) rather than receiving their care through the traditional fee-for-service (FFS) Medicare program. The decision to allow seniors to enroll in HMOs was heralded by economists for the potential cost savings, and by geriatricians for the potential improvements in patient care in a more highly integrated system.1-4 Integration of care assumes heightened importance in the care of patients with chronic illness, as is predominantly the case with Medicare beneficiaries (87%).5 A hallmark of the HMO model is its pairing of patients with a single, primary physician who assumes responsibility for coordinating and approving all aspects of the patient's care.

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