Social/health maintenance organization and fee-for-service health outcomes over time
Manton, K.G.; Newcomer, R.; Lowrimore, G.R.; Vertrees, J.C.; Harrington, C.
Health Care Financing Review 15(2): 173-202
1993
ISSN/ISBN: 0195-8631 PMID: 10135342 Document Number: 412504
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.