Targeting Expanded Care to the Aged: Early SHMO Experience

For the past 2½ years, four Social Health Maintenance Organization (SHMO) sites have been delivering integrated, prepaid, acute, and chronic care to Medicare beneficiaries. Because SHMOs enroll a mix of able-bodied and frail members, sites have had to develop systems for identifying disabled members...

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Bibliographic Details
Published in:The Gerontologist 1988-02, Vol.28 (1), p.4-17
Main Authors: Leutz, Walter, Abrahams, Ruby, Greenlick, Merwyn, Kane, Rosalie, Prottas, Jeffrey
Format: Article
Language:English
Subjects:
Aged
Case management
Chronic care
Community care
Comprehensive Health Care - organization & administration
Costs and Cost Analysis
Criteria
Gerontology
Health maintenance organizations
Health Maintenance Organizations - organization & administration
HMOs
Humans
Long-term care
Long-Term Care - economics
Medicare
Older people
People with disabilities
United States
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Summary:For the past 2½ years, four Social Health Maintenance Organization (SHMO) sites have been delivering integrated, prepaid, acute, and chronic care to Medicare beneficiaries. Because SHMOs enroll a mix of able-bodied and frail members, sites have had to develop systems for identifying disabled members who may qualify to receive expanded chronic care benefits. Selection criteria for targeting expanded benefits, and their implementation affect costs, outcomes, and equity. Described are the sites' targeting policies and analyzed are the complexities of operationalizing targeting systems in four different settings.
ISSN:0016-9013
1758-5341
DOI:10.1093/geront/28.1.4