Information Requirements for Health Maintenance Organizations

Health Maintenance Organizations have been proposed as a major element in the restructuring of the health care delivery system to help contain costs and bring about improved distribution of services. The structure and responsibilities of these new organizations will present new and challenging management problems for health services administrators. This paper discusses the differences between the HMO and traditional health care delivery concepts with an emphasis on the different incentives faced by the three major components of any delivery system: patient, provider, and plan (management). The paper then outlines the important planning, operation, and control activities which must take place to assure that the responsibilities of HM0s are met, and examines the implications of these activities for the design of supporting management information systems.