Social/health maintenance organization and fee-for-service health outcomes over time

Evaluating the performance of long-term care (LTC) demonstrations requires longitudinal assessment of multiple outcomes where selective mortality and disenrollment, if not accounted for, can give the appearance of reduced (or enhanced) efficacy. We assessed outcomes in social/health maintenance orga...

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Bibliographic Details
Published in:Health care financing review 1993, Vol.15 (2), p.173-202
Main Authors: Manton, K G, Newcomer, R, Lowrimore, G R, Vertrees, J C, Harrington, C
Format: Article
Language:English
Subjects:
Activities of Daily Living
Aged
Capitation
Capitation Fee - standards
Caregivers
Case management
Comparative analysis
Cost-Benefit Analysis
Costs
Demographics
Diagnosis-Related Groups - statistics & numerical data
Evaluation
Fees, Medical - statistics & numerical data
Female
Health maintenance organizations
Health Maintenance Organizations - economics
Health Maintenance Organizations - statistics & numerical data
Health Services for the Aged - economics
Health Services for the Aged - statistics & numerical data
Health Services Research
HMOs
Hospital Payment: Beyond the Prospective Payment System
Humans
Institutionalization
Insurance, Health, Reimbursement
Life Expectancy
Long term health care
Long-Term Care - economics
Long-Term Care - statistics & numerical data
Long-term care insurance
Male
Medicaid
Medical screening
Medicare
Medicare - economics
Medicare - statistics & numerical data
Models, Statistical
Mortality
Multivariate analysis
Nursing homes
Older people
Outcome and process assessment (Health Care)
Prospective payment systems (Medical care)
Quality of life
Studies
Treatment Outcome
United States
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Description
Summary:Evaluating the performance of long-term care (LTC) demonstrations requires longitudinal assessment of multiple outcomes where selective mortality and disenrollment, if not accounted for, can give the appearance of reduced (or enhanced) efficacy. We assessed outcomes in social/health maintenance organizations (S/HMOs) and Medicare fee-for-service (FFS) care using a multivariate model to estimate active life expectancy (ALE). S/HMO enrollees and samples of FFS clients in four sites were analyzed and outcome differences assessed for a 3-year period. Results provide insights into S/HMO performance under different conditions and, more generally, into evaluating LTC demonstrations without randomized client and control groups.
ISSN:0195-8631
1554-9887