ESSENTIAL COMPONENTS OF GERIATRIC CARE PROVIDED THROUGH HEALTH MAINTENANCE ORGANIZATIONS

The rapid growth in the number of older adults enrolling in health mai ntenance organizations (HMO) presents a number of opportunities and ch allenges. Older HMO enrollees have needs that differ from those of you nger enrollees, such as the medical conditions they face, their likeli hood of having functional deficits, and differences in their living ar rangements. In addition, their health-related needs often extend beyon d medical care and may include relationships with families, caregivers , and community agencies. This article describes the types of services that should realistically be available to older adults who are enroll ed in an HMO with a Medicare risk contract in order to meet the goals of geriatric care: to promote health, independence, and optimal functi oning, to prevent avoidable decline in health status, and to enhance q uality of life. The findings are based on deliberations during the pas t year by the HMO Workgroup on Care Management, which was convened und er the auspices of The Robert Wood Johnson Foundation's national progr am, ''Chronic Care Initiatives in HMOs.''