The Continuing Evolution of Health Maintenance Organizations

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Abstract
Of the various health-care systems currently available to the American people, Health Maintenance Organizations (HMO's) most nearly meet the objective of providing access to high-quality comprehensive medical and health-care services at the most reasonable cost possible. Preventive services, early disease detection, diagnosis and treatment of illness and injury are all equally emphasized in the HMO. Several decades of successful growth by prototype prepaid group-practice plans have brought national attention from both the public and private sectors to focus on HMO's. Basic principles for developing an effective HMO include prepayment, a contractual responsibility between the plan and its members, an autonomous and self-governing physicians' organization, physicians' payment influenced by shared financial responsibility, integrated services, voluntary enrollment and comprehensive coverage. The groundwork is now being laid for development of manpower resources for HMO's, with several medical schools having recently established HMO-like models to serve as training sites for future practitioners.