S/HMO versus TEFRA HMO enrollees: Analysis of expenditures

Bryan E Dowd, Steve Hillson, Tom VonSternberg, Lucy Rose Fischer

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

This study compares expenditures on health care services for enrollees in a social health maintenance organization (S/HMO) and a Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA)-risk Medicare health maintenance organization (HMO). In addition to the traditional Medicare services covered by the TEFRA HMO, the S/HMO provided a long-term care (LTC) benefit and case management services for chronic illness. There do not appear to be any overall savings associated with S/HMO membership, including any savings from substitution of S/HMO-specific services for other, traditional services covered by both the S/HMO and the TEFRA HMO.

Original languageEnglish (US)
Pages (from-to)7-23
Number of pages17
JournalHealth Care Financing Review
Volume20
Issue number4
StatePublished - Oct 25 1999

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