| Title: |
Health Maintenance Orqanization (HMO) Performance and Consumer Complaints: An Empirical Study of Frustrating HMO Activities. |
| Authors: |
Born, Patricia H.1; Query, J. Tim2 |
| Source: |
Hospital Topics. Winter2004, Vol. 82 Issue 1, p2-9. 8p. 3 Charts. |
| Subject Terms: |
*Health maintenance organizations; *Managed care programs; *Health facilities utilization; *Medical care; *Health insurance |
| Geographic Terms: |
United States |
| Abstract: |
Growing public interest in the operations of managed care plans has fueled a variety of activities to collect and analyze their performance. These activities include studies of financial performance, analysis of enrollment decisions, and, more recently, the development of systems for measuring healthcare quality to improve accountability to consumers. In this study, the authors focus on the activities of managed care plans that may frustrate patients and providers and, subsequently, motivate patients to file complaints. Using data from three sources, they evaluate the relationships between complaints against managed care plans and two metrics of performance: (a) the financial performance of the plan, and (b) the quality of care provided. Their findings indicate that complaints against health maintenance organizations are significantly related to the plans' levels of quality and to actions that may impede access to care. [ABSTRACT FROM AUTHOR] |
| : |
Copyright of Hospital Topics is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| Database: |
Business Source Premier |