U.S. National Library of Medicine

Introduction to Health Services Research : A Self-Study Course

Module 2: Brief History of Health Services Research (Page 33 of 40)

Impact of HMOs on Patients and Consumers

Patient Complaints about HMO Care

Throughout the 1990s patients and consumer groups complained that they did not receive quality services in some prepaid health care arrangements.

They were concerned with losing continuity of care with their personal physician as health plans added and deleted doctors from their networks.

States Shift Medicaid Recipients into Managed Care

State and local public health departments began shifting Medicaid recipients into managed care arrangements to save dollars and to provide access to care. However, the loss of Medicaid funds from public health agencies due to economic downturns can leave uninsured and indigent populations without the health care the health departments provided with federal funding.

View Key Projects and Milestones in Health Services Research.

Discussion Questions

1. What were the problems patients in HMOs identified during the 1990s? How would you learn what problems patients in HMOs are facing now?
2. How are those in poverty reacting to getting health care in a managed care environment? Have recent state funding problems affected who is getting health care? Has the number of uninsured increased? Decreased? Or remained steady? Why is it important for you to know what the uninsured rate is at any time? How would you find out?
3. What protections, if any, do those in poverty face when receiving care from HMOs? How would you learn what those problems are?
4. Do changes in how health care is provided such as when managed care came along create research opportunities for health services researchers? Explain.
5. Is it important to track changes in the health care environment so as to be better prepared for responding to research questions in a changing health care environment? What are your favorite sources of current health care news?