Do HMOs make a difference? Summary and implications

The findings of this study of the effects of health maintenance organizatio ns (HMOs) have implications for consumers' choice between HMOs and other ty pes of insurance: consumers face a trade-off that flows in part from the de sign of HMOs. HMO enrollees get more primary and preventive care and face l ower out-of-pocket costs, bur they get less specialist care, experience mor e provider access and organizational barriers to care, and report less sati sfaction, lower ratings of care, and less trust ill their physicians. Polic ymakers should recognize that this trade-off will be attractive to some peo ple but not to others.