journal article
The Health Maintenance Organization Act of 1973 (P.L. 93-222) and Prepaid Group Practice PlansMedical Care
Vol. 13, No. 1 (Jan., 1975)
, pp. 1-9 (9 pages)
Published By: Lippincott Williams & Wilkins
//www.jstor.org/stable/3763270
Read and download
Log in through your school or library
Abstract
Passage of the 1973 Health Maintenance Organization Act (P.L. 93-222) represents a significant effort by the Federal government to experiment with organizational change in the structure of the health care delivery system. The history of the bill is briefly reviewed. The most important sections of the bill are analyzed from the perspective of an existing prepaid group practice plan. The author concludes that the bill contains sufficiently stringent requirements that it will not result in a major increase in the number of Health Maintenance Organizations unless similar requirements are imposed on other private insurance carriers. Furthermore, significant allowance for "phasing in" will be required for the existing prepaid group practice prototype plans to qualify for Federal certification.
Journal Information
Rated as one of the top ten journals in healthcare administration, Medical Care is devoted to all aspects of the administration and delivery of healthcare. This scholarly journal publishes original, peer-reviewed papers documenting the most current developments in the rapidly changing field of healthcare. This timely journal reports on the findings of original investigations into issues related to the research, planning, organization, financing, provision, and evaluation of health services.
Publisher Information
Wolters Kluwer Health is a leading provider of information for professionals and students in medicine, nursing, allied health, pharmacy and the pharmaceutical industry. Major brands include traditional publishers of medical and drug reference tools and textbooks, such as Lippincott Williams & Wilkins and Facts & Comparisons; electronic information providers, such as Ovid Technologies, Medi-Span and ProVation Medical; and pharmaceutical information providers Adis International and Source®. Wolters Kluwer Health is a division of Wolters Kluwer, a leading multi-national publisher and information services company with annual revenues (2005) of €3.4 billion and approximately 18,400 employees worldwide. Wolters Kluwer is headquartered in Amsterdam, the Netherlands. Its depositary receipts of shares are quoted on the Euronext Amsterdam (WKL) and are included in the AEX and Euronext 100 indices.
Rights & Usage
This item is part of a JSTOR Collection.
For terms and use, please refer to our Terms and Conditions
Medical Care © 1975 Lippincott Williams & Wilkins
Request Permissions
IT IS with great pleasure that I today sign into law S. 14, the Health Maintenance Organization Act of 1973. This legislation will enable the Federal Government to help demonstrate the feasibility of the HMO concept over the next 5 years.
Expanding the geographic distribution of health maintenance organizations is an integral part of the National Health Strategy that I first proposed nearly 3 years ago. S. 14 is somewhat broader than the Administration's proposal, but it nevertheless contains the essential concepts and principles that I support. It will provide initial Federal development assistance for a limited number of demonstration projects, with the intention that they become self-sufficient within fixed periods.
The national health insurance bill that I will be submitting to the next session of this Congress will allow patients to use such insurance to join HMO's. For that reason, it is particularly important that this demonstration effort get underway immediately and build upon the momentum which has already been achieved in this field.
Health maintenance organizations provide health care to their members on a prepaid basis with emphasis on essential preventive services. The establishment of HMO's will allow people to select for themselves either a prepaid system for obtaining health services or the more traditional approach which has served the American people so well over the years.
The Health Maintenance Organization Act makes Federal demonstration assistance available both to organized group practices and to medical foundations which provide prepaid care, further encouraging a diversified medical care system. HMO's which receive assistance under this act would agree to provide a comprehensive package of basic benefits, including essential preventive services, along with a list of supplemental benefits for which the enrollee could make an extra payment.
Under S. 14, the Government would provide financial assistance to help various groups determine the feasibility of developing an HMO in their area, as well as assistance for planning and initial development. HMO's would be required to operate competitively without Federal subsidies at the end of an initial period of Federal support.
S. 14 represents one response to the challenge of finding new. and better ways to improve health care for the people of this country. It will build on the partnership that exists between the Federal and private sector by allowing both the provider and the consumer of health services to exercise the widest possible freedom of choice.
The signing of this act marks another milestone in this Administration's national health strategy. The major task of providing financial access to health services should be addressed in the next session of this Congress with the enactment of an appropriate and responsive national health insurance act.
Richard Nixon, Statement on Signing the Health Maintenance Organization Act of 1973 Online by Gerhard Peters and John T. Woolley, The American Presidency Project //www.presidency.ucsb.edu/node/255906