Why primary care physicians join HMOs

Objective: To determine the reasons why primary care physicians affiliate w ith health maintenance organizations (HMOs) and assess how these reasons va ry with personal and practice characteristics. Study Design: A 1996 national telephone/mail survey of primary care physici ans who were affiliated with at least 1 HMO plan for more than 9 months. Methods: Survey responses were assessed according to geographic region, age , income, level of involvement in managed care, and HMO penetration rate. T he sample consisted of 210 primary care physicians who played a role in the decision to affiliate. Results: The overwhelming reason primary care physicians affiliated with an HMO was to retain patients. Eighty-three percent reported this as one of t he reasons for affiliating and 59% reported it as the primary reason. Physi cians with the greatest portion of income from managed care and physicians practicing in areas with high HMO penetration were most likely to report qu ality of life issues-such as more personal time, more predictable work hour s, or reduced administrative burden-as the rationale for HMO plan affiliati on. Conclusions: These findings support the view that the majority of HMO-affil iated physicians join HMOs to avoid a perceived penalty associated with lac k of affiliation, rather than for positive reasons. The data also suggest t hat physicians with managed care experience affiliate more often for qualit y of life reasons.