US HMO Enrollment Set To Grow, Despite Concerns

Enrollment in US health maintenance organizations is continuing to growrapidly, despite concerns by consumers, political leaders and the media about access, quality of care and HMOs' ability to control hospitalization and treatment, says a recent survey by Deloitte & Touche LLP and VHA.

The study, Redesigning Health Care for the Millennium: A 1997 Assessment of the Health Care Environment in the United States, notes that in 1995, HMO national penetration reached almost 26%, up from 21% in 1994, and it describes this trend as tolling the death knell for traditional indemnity care plans.

Since 1993, for-profit HMOs have generally been able to post improved financial results by keeping their medical loss ratios lower than not-for-profit HMOs. However, concerns over access, control and quality of care in for-profit HMOs are growing, with federal and state legislation covering these issues and President Clinton creating a national commission to study them. Purchasers' wishes, preferences and demands are becoming clear, with point-of-service and open-ended plan types growing most rapidly as customers continue to prefer their flexibility.