The Effects of an Experimental Prepaid Group Practice on Medical Care Utilization and Cost

Rates of utilization and costs of medical care by a study group in a prepaid group practice, the Medical Care Group of Washington University (MCG), were compared prospectively over a three-year period with those of a demonstrably similar control group cared for by fee-for-service private physicians. MCG enrollees used twice the ambulatory services control enrollees did (p=less than 0.01), but used 23 per cent fewer hospital days (p=less than 0.01). Cost per diagnostic and therapeutic visit was similar for both groups; MCG preventive visits cost more. Increased numbers of MCG services provided led to increased ambulatory care costs for MCG over controls. Hospital utilization savings did not compensate for these increased costs. Thus prepayment in an organized setting did change hospital and ambulatory care utilization but did not reduce medical care costs. Other changes in medical care besides those which result from a different organization of medical care are discussed which might make control of medical care costs more likely

Ambulatory · Ambulatory care · Business · Family medicine · Health care · Medical care · Medical costs · Medical emergency · Medical services · Prepayment of loan · Emergency Medicine · Finance · Healthcare Policy and Management · Internal Medicine · Medicine · Patient Satisfaction in Healthcare · Primary Care and Health Outcomes

• Mode of Payment as a Predictor of Health Status, Use of Health Services and Preventive Health Behavior

  Alfred C Marcus•Medical Care•1981

  Incluir item

• An Effect of Organization of Medical Care Upon Health

  Gerald T Perkoff•Medical Care•1978

  Incluir item

• Influencing Behavior of Physicians Ordering Laboratory Tests

  Petra Axt-Adam, Johannes C van der Wouden et al.•Medical Care•1993

  Incluir item

• Experiments and Demonstrations in Health Services Research

  Lee Sechrest•Medical Care•1985

  Incluir item

• Surgical Utilization Statistics

  Vicki L Sauter, Edward F X Hughes•Medical Care•1983

  Incluir item

• Optimal Investigation Policies Under Selected PSRO Procedures

  David A Dittman, Robert P Magee•Medical Care•1980

  Incluir item

• Interrelationships of Physician Performances

  Sang-O Rhee, Thomas Lyons et al.•Medical Care•1978

  Incluir item

• Comparing the Medical Utilization and Expenditures of Low Income Health Plan Enrollees with Medicaid Recipients and with Low Income Enrollees Having Medicaid Eligibility

  Richard E Johnson, Daniel J Azevedo•Medical Care•1979

  Incluir item

• HMOs in the U.S.A. and Britain

  Open Access•Geof Rayner•Social Science & Medicine•1988

  Incluir item

• Rationing or rationalizing children's medical care

  Jane Mauldon, Arleen Leibowitz et al.•American Journal of Public Health•1994

  Incluir item

• Patterns of medical use by the indigent aged under two systems of medical care

  S Shapiro, Judith J Williams et al.•American Journal of Public Health…•1967

  Incluir item

• Comparison of Prematurity and Perinatal Mortality in a General Population and in the Population of a Prepaid Group Practice, Medical Care Plan

  Sam Shapiro, Louis Weiner et al.•American Journal of Public Health…•1958

  Incluir item

• Prepaid Medical Care and Hospital Utilization in a Dual Choice Situation

  Paul M Densen, Ellen W Jones et al.•American Journal of Public Health…•1960

  Incluir item

• Frequency of Referral and Patient Characteristics in Group Practice

  Roy Penchansky, Daniel Fox et al.•Medical Care•1970

  Incluir item

• Medical Care Utilization in an Experimental Prepaid Group Practice Model in a University Medical Center

  Gerald T Perkoff, Lawrence Kahn et al.•Medical Care•1974

  Incluir item

• Prepaid Group Practice in Sault Ste. Marie, Ontario

  Frederick D Mott, J E F Hastings et al.•Medical Care•1973

  Incluir item

• Approaches to Moderating the Increases in Medical Care Costs

  Herbert E Klarman•Medical Care•1969

  Incluir item