Quality of Care in Investor-Owned vs Not-for-Profit HMOs

Abstract
Health maintenance organizations (HMOs) have been both derided and defended. Studies comparing HMOs with fee-for-service care have generally found similar outcomes for the average, healthy enrollee. However most,1-8 but not all,9,10 studies have found worse outcomes in managed care for vulnerable groups (ie, the seriously ill, the mentally ill, and the poor). Both patients and physicians are less satisfied with care delivered through HMOs.11-16