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The purpose of this paper is to estimate whether health maintenance organizations (HMO) physicians are more price sensitive than non‐HMO physicians in their prescribing behavior of brand‐name substitutes.

The study uses physician level data and a set of 13 drugs for the years 1997‐2000 to estimate the price sensitivity of HMO and non‐HMO physicians. A two‐part model is used to measure the price elasticity of brand‐name prescribing for HMO physicians. The first part uses a logit model to examine the physician's choice to prescribe the same drug to all patients with the same medical condition, or whether physicians alternate prescriptions among brand‐name substitutes. The second part employs OLS to estimate the influence of managed care, i.e. HMOs, on physician price sensitivity.

The results suggest that HMO physicians are less likely than non‐HMO physicians to prescribe a common drug to all patients with a specific medical condition, but rather HMO physicians exhibit more diversified prescribing behavior. Correspondingly, HMO physicians are more price sensitive in prescribing brand‐name substitutes, than non‐HMO physicians, exhibiting price elasticities of prescribing ranging from −1.707 to −1.823. The analysis suggests that HMOs have a modest influence on encouraging physicians to be more price sensitive in their prescribing of brand‐name substitutes. HMO physicians are more price sensitive in their prescribing behavior than non‐HMO physicians.

This paper provides insight into the effectiveness of HMOs in altering physician prescribing behavior and price sensitivity of pharmaceutical prices. The results provide suggestions on how HMOs can improve the cost‐effectiveness of physician prescribing behavior.

We determined access and satisfaction of 2,598 recipients of Virginia’s Medicaid program, comparing its health maintenance organizations (HMOs) to its primary care case management (PCCM) program. Positive responses were summed as sub‐domains either of access, satisfaction, or of utilization, and adjusted odds ratios were calculated for HMO (vs. PCCM) sub‐domain scores. The response rate was 47 per cent. We found few significant differences in perceived access, satisfaction, and utilization. Both HMO adults and children more often perceived good geographic access (adults, OR, [CI] = 1.50, [1.04‐2.16]; children, OR, [CI] = 1.773 [1.158, 2.716]). But HMO patients less often reported good after‐hours access (adults, OR, [CI] = 0.527 [0.335, 0.830]; children, OR, [CI] = 0.583 [0.380, 0.894]). Among all patients reporting poorer function, HMO patients more often reported good general and preventive care (OR, [CI] = 2.735 [1.138, 6.575]). We found some differences between Medicaid HMO versus PCCM recipients’ reported access, satisfaction, and utilization, but were unable to validate concerns about access and quality under more restrictive forms of Medicaid managed care.

In the USA, health maintenance organizations (HMOs) have pledged to control health care costs. Many patients have complained about the quality of care under the HMO regime and limits imposed on them, particularly access to care. Has quality of care been degraded under the HMO regime, resulting in an impact on patient satisfaction? There have been many studies that have compared the satisfaction of HMO patients with that of patients in the traditional fee‐for‐service payment system. The aim of this paper is to review HMO patient satisfaction.

A review of patient satisfaction under managed care arrangements with a focus on HMOs. The article describes the US history of managed care and its effect on the satisfaction of several patient categories including the general population, vulnerable patients and the elderly.

There is much information available on patient satisfaction with their insurers and most surveys indicate the lack of choice of a provider – a major source of discontent. Therefore, patient protection laws are necessary to avoid abuse.

Patients have little ability or are not willing to rely on the information available when selecting a provider. The paper discusses patient awareness regarding satisfaction surveys and how the latter can be used when patients are seeking care.

The purpose of this research is to examine the potential contribution of private branding to the service sector, and to integrate private branding into the SERVQUAL model.

A total of 300 customers of a health maintenance organization (HMO) were asked about the five dimensions of the service‐quality model and about several aspects of their HMO's private brand.

The study finds that satisfaction with service quality among subjects who were aware of the HMO's private brand was higher than that of unaware subjects when asked directly. In addition, a positive relationship was found between the perceptions of service quality in the HMO and the evaluation of a private brand in the HMO those customers who were aware of the private brand. The data analysis suggests that private branding constitutes an additional (sixth) dimension in the SERVQUAL model.

This research was conducted during the initial stages of the market penetration of the HMO's private brand.

HMOs, and other service providers, should consider private branding as a pivotal strategy in reinforcing service quality.

This research is of importance for service providers because it identifies private branding strategy as having significant marketing potential for improving service quality.

Previous research has established that there is a relationship between housing and mental health, however, understanding about how and why housing affects mental health is still limited. The purpose of this paper is to address this deficit by focusing on the experiences of residents of houses in multiple occupation (HMOs).

Semi-structured interviews were carried out with 20 HMO residents who were asked about their housing career and experience of living in a HMO. Participants were recruited with assistance from community organisations and landlords.

The physical properties and social environment of the property, as well as personal circumstances experienced prior to the move into the property, all influenced how mental health was affected. The authors identify and discuss in detail three key meditating factors: safety, control and identity which may affect how living in the property impacts the mental health of tenants.

Good property management can lessen the potential harmful effects of living in a HMO. However, poorly run properties which house numerous vulnerable people may increase the risk of poor mental health due to attendant high levels of stress and possible risk of abuse.

Based on the reports of HMO residents, the authors outline the key mediating processes through which living in HMOs may affect mental wellbeing, as well as illuminating the potential risks and benefits of HMOs, an overlooked tenure in housing research.

Perhaps the most remarkable event in the US medical market in the last ten years has been the astonishing growth of the new kinds of health‐care delivery systems that are collectively known as health maintenance organisations (HMOs). Indeed, they are now posing a serious threat to the conventional insurance sector which has traditionally covered most Americans. According to data collected by the US Department of Health and Human Services and the Minnesota research foundation, InterStudy, some 18.9 million people were enrolled in an HMO in June 1985, so that the 400 HMOs then in existence accounted for roughly nine per cent of the health‐care market. Today's figures are undoubtedly higher, and one New York investment company expects that ‘by 1990, 75 million people, or 30 per cent of the population, will be members of HMOs’, with the organisations achieving ‘membership expansion and revenue growth of 30–40 per cent a year’

Examines the relationship between the presence of financial incentives and their effect on physician behaviour in health maintenance organizations (HMOs). By reviewing the scope and dimensions of both HMOs and financial incentives, a foundation is laid for the review of the current empirical evidence. Further analysis and conceptual development is given to this topic by stating the limitations of existing research – in the confounding variables, in the complexity of incentives, and in the unanswered questions of quality of care – and by proposing innovative ways of studying the “other aspects of physician behaviour” not previously considered. Questions and implications are raised for future research and practice.

Estimates a total effects cost function using a national 1994 health maintenance organization (HMO) data set to examine and update findings related to HMO efficiency. The cost function controls for ownership characteristics (profit status and ownership), size, enrollment diversity, regional location, product diversity, model type, payment characteristics, and years of operation. While not explicitly controlling for quality or acuity, measures of plan and enrollee diversity help control for acuity and quality. Results show that most of the difference in cost efficiency between HMOs is explained by factors specific to the HMO, including efficiencies of scale and scope, lower levels of Medicare patients, and efficient levels of capital. The study also shows that for‐profits are more efficient than non‐profits because they rely less on withhold pools to control costs. Limitations of the study include weak controls for quality of care, and limited data related to payment characteristics.

Tests the theory that owners (hospital, physician, insurance) of vertically integrated health maintenance organizations (HMOs) might substitute towards production of their own specialty goods. Uses data from various sources in the USA. Determines the impact of ownership on factors such as average physician ambulatory services per enrollee and average hospital days per enrollee. Concludes that policymakers need to encourage the development of standard publicly available quality measures to intensify competition and eliminate excess profits accruing to provider‐owners who substitute towards production of their own goods.

The spiraling cost of health care is emerging as one of the country's most urgent problems and a major domestic political issue. In the 1940s, prepaid medical care provided by groups of health‐care professionals began to take hold and finally emerged as a serious prospect for cost‐effective health care with the passage of the Health Maintenance Organization Act of 1973 (42 U.S.C. 300e). Although still not widespread, interest in HMOs is growing and government incentives to private investment in such organizations should prompt inquiries to libraries from citizens groups, businesspeople, and potential customers of these services. Here is a sampling of items on the subject.