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How Health Maintenance Organizations Control Costs

HRD-82-31 Published: Dec 29, 1981. Publicly Released: Dec 29, 1981.
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Highlights

GAO evaluated health maintenance organizations' (HMO's) attempts to reduce health care costs. GAO analyzed the results of a questionnaire sent to members and former members of 12 HMO's concerning their satisfaction with health services and compared the HMO premiums with those that a health insurance company would charge for the same benefits.

Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Department of Health and Human Services The Secretary of HHS should direct the Office of Health Maintenance Organizations to communicate to all federally qualified HMO's the utilization and cost control techniques identified. They should be presented as a means to assist financially troubled and beginning HMO's in identifying techniques to help control hospital utilization and reduce health care costs. Older, financially sound HMO's should find them helpful in identifying methods to further reduce health care costs.
Closed – Implemented
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

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Topics

Cost controlEmergency medical servicesHealth care cost controlHealth care costsHealth insuranceHealth maintenance organizationsHospital care servicesPhysiciansHealth resources utilizationPatient care